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Organization

FAMILY FARE, LLC

Active
Other names
FAMILY FARE PHARMACY 339
Organization subpart
No

Provider details

NPI number
Authorized official
AMY ELLIS (DIRECTOR OF PHARMACY)
(616) 878-2848
Entity
Organization

Contact information

Practice address
2755 LAKE MICHIGAN DR NW, GRAND RAPIDS, MI 49504-5872
(616) 791-4777
(616) 791-8110
Mailing address
1527 MOMENTUM PL, SPARTAN PHARMACY NORTH, CHICAGO, IL 60689-5315
(616) 878-8584

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5301007082
MI
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2345456
OTHER ID NUMBER-COMMERCIAL NUMBER
05
4147323
MI
Enumeration date
09/25/2006
Last updated
12/07/2023
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