Ericksons Diversified LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

ERICKSONS DIVERSIFIED LLC

Doing business as

ECONOFOODS PHARMACY
FAMILY FARE PHARMACY 3330

Practice address

603 Division St S
Northfield, MN 55057-2426

Phone

(507) 645-4489

Fax

(507) 663-1006

NPI assigned

Jan 5, 2007

Organization subpart

No

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

Addresses

Other identifiers 1

Other names 2

• ECONOFOODS PHARMACY Doing business as
• FAMILY FARE PHARMACY 3330 Doing business as

Locations

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1043368319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 MOMENTUM PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 DIVISION ST S",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572426",
            "telephone_number": "507-645-4489",
            "fax_number": "507-663-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICKSONS DIVERSIFIED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "951060500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ECONOFOODS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ECONOFOODS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FAMILY FARE PHARMACY 3330",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hannah Enge
• Macy Erickson, PT, DPT
• Monica Rae Erickson, ATC
• Samuel Erickson, ATC, CSCS
• Tiffany Mary Erickson, MS, A.T.C
• Katsiaryna Ericson, MD
• Angela Dawn Erspamer, LPCC
• Evergreen Therapy Solutions
• Dawn Stueven Fadden, RN, CNP
• Benjamin Mark Faustich, M.D.

• Community/Retail Pharmacy in Northfield, MN
• Providers in Northfield, MN by specialty
• Community/Retail Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; 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.