Organization Active NPI

Prevos Family Markets LLC

  • Community/Retail Pharmacy
  • Caledonia, MI
National Provider Identifier
1003973561
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301008371 Issued in MI
Legal business name
PREVOS FAMILY MARKETS LLC
Practice address
9375 Cherry Valley Ave SE
Caledonia, MI 49316-9506
Phone
(616) 891-7898
Fax
(616) 891-8097
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amy Ellis, RPH
Title
Director of Pharmacy
Phone
(616) 878-2848

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 5301008371 MI Primary

Addresses

Primary practice location

9375 Cherry Valley Ave SE
Caledonia, MI 49316-9506

Mailing address

Spartan Pharmacy North
1527 Momentum Place
Chicago, IL 60689-5315
Phone (616) 878-8584

Other identifiers 1

IdentifierTypeStateIssuer
2042552OtherPK

Other names 1

  • D & W PHARMACY 1577 Doing business as

National Provider Directory

National Provider Directory

Locations

1550 Gezon Pkwy SW
Ste E
Wyoming, MI 49509
Phone (616) 878-2741

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785974400000",
    "number": "1003973561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SPARTAN PHARMACY NORTH",
            "address_2": "1527 MOMENTUM PLACE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895315",
            "telephone_number": "616-878-8584",
            "fax_number": "616-878-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9375 CHERRY VALLEY AVE SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493169506",
            "telephone_number": "616-891-7898",
            "fax_number": "616-891-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVOS FAMILY MARKETS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "616-878-2848",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301008371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2042552",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "D & W PHARMACY 1577",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "D & W PHARMACY 1577",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Caledonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.