Active NPI
Family Fare, LLC
Doing business as Family Fare Pharmacy #158
- Pharmacy
- Wyoming, MI
National Provider Identifier
1093287443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- FAMILY FARE, LLC
- Doing business as
- Family Fare Pharmacy #158
- Practice address
- 1550 Gezon Pkwy SW Ste E-101
Wyoming, MI 49509-9397 - Phone
- (616) 878-8111
- NPI assigned
- Dec 26, 2018
- Last updated
- Dec 7, 2023
- Organization subpart
- No
NPPES NPI Registry
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | NU | Primary |
Addresses
Primary practice location
1550 Gezon Pkwy SW Ste E-101
Wyoming, MI 49509-9397
Mailing address
1550 Gezon Pkwy SW Ste E-101
Wyoming, MI 49509-9397
Phone (616) 878-8111
Other names 1
- FAMILY FARE PHARMACY #158
National Provider Directory
National Provider Directory- Tax ID family
- Family Fare LLC
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Family Fare - Forest Hills Pharmacy
- Community/Retail Pharmacy
- Grand Rapids, MI
- NPI 1780928473
-
dba Family Fare Pharmacy #1524
- Community/Retail Pharmacy
- Gladwin, MI
- NPI 1184902090
Locations
1550 Gezon Pkwy SW
Ste E101
Wyoming, MI 49509
Phone (616) 878-8111
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545782400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1701907200000",
"number": "1093287443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1550 GEZON PKWY SW STE E-101",
"city": "WYOMING",
"state": "MI",
"postal_code": "495099397",
"telephone_number": "616-878-8111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1550 GEZON PKWY SW STE E-101",
"city": "WYOMING",
"state": "MI",
"postal_code": "495099397",
"telephone_number": "616-878-8111"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY FARE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-12-26",
"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",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "FAMILY FARE PHARMACY #158",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "FAMILY FARE PHARMACY #158",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Wyoming, MI
Sources for this page
- 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.