Prevos Family Markets LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301008628 Issued in MI

Legal business name

PREVOS FAMILY MARKETS LLC

Practice address

902 W State St
Hastings, MI 49058-1661

Phone

(269) 945-2466

Fax

(269) 945-2991

NPI assigned

May 25, 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 1

Addresses

Other identifiers 2

Other names 1

• Family Fare Pharmacy #1990 Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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

• Hailey Summers

  • Pharmacist
  • Hastings, MI
  • NPI 1477435949
  NPD (past)

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785974400000",
    "number": "1194936682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 MOMENTUM PL",
            "address_2": "SPARTAN PHARMACY NORTH",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895315",
            "telephone_number": "616-878-8584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 W STATE ST",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490581661",
            "telephone_number": "269-945-2466",
            "fax_number": "269-945-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVOS FAMILY MARKETS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301008628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1194936682",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2369723",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Fare Pharmacy #1990",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Fare Pharmacy #1990",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Poholski, DO
• Kimberly Porter, CNM, WHNP-BC
• Dikshita Poudel, MD
• Nilesh Maraj Prashad, MD
• Jacob Pratt, LLBSW
• Purucker Counseling Services PLLC
• Colette Purucker, LMSW
• Ronika Rai
• Gregory Thomas Randall, DDS
• Karlie Raphael

• Community/Retail Pharmacy in Hastings, MI
• Providers in Hastings, 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 Aug 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.