Family Fare, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301009029 Issued in MI

Legal business name

FAMILY FARE, LLC

Doing business as

VG's Pharmacy #1930

Practice address

8503 Davison Rd
Davison, MI 48423-2116

Phone

(810) 658-9710

Fax

(810) 658-6459

NPI assigned

Dec 9, 2008

Organization subpart

No

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

Authorized official

Name

Amy Ellis

Title

Director of Pharmacy

Phone

(616) 878-2848

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• VG's Pharmacy #1930 Doing business as

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1053556753",
    "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": "8503 DAVISON RD",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484232116",
            "telephone_number": "810-658-9710",
            "fax_number": "810-658-6459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY FARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-09",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "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"
    },
    "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": "5301009029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2118101",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VG's Pharmacy #1930",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VG's Pharmacy #1930",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Manoharan W Eustace, MD
• Tara Rae Evans, NP-C
• David Lee Ewing, DDS
• Eyecare Associates
• Mary F Fairweather, RPH
• Family Orthopedic Associates P L C (OrthoMichigan Therapy Services)
• Family Orthopedic Associates P L C (OrthoMichigan Therapy Services)
• Farhan Family Medicine
• Thaer Jamal Farhan, DO
• Paul Fatell, PH.D.

• Community/Retail Pharmacy in Davison, MI
• Providers in Davison, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.