Organization
ERICKSONS DIVERSIFIED LLC
Active
Other names
FAMILY FRESH MARKET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ELLIS RPH (DIRECTOR OF PHARMACY)
(616) 878-2848
Entity
Organization
Contact information
Practice address
612 S MINNESOTA AVE, SAINT PETER, MN 56082-2100
(507) 931-5540
(507) 931-9028
Mailing address
1527 MOMENTUM PL, CHICAGO, IL 60689-5315
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
2008521
MN
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2408753
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
342358100
—
MN
Enumeration date
01/05/2007
Last updated
10/29/2025
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