Prevos Family Markets LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301009135 Issued in MI

Legal business name

PREVOS FAMILY MARKETS LLC

Doing business as

Family Fare Pharmacy #647

Practice address

1057 US Highway 31 S
Manistee, MI 49660-2270

Phone

(231) 398-3202

Fax

(231) 398-3246

NPI assigned

May 21, 2009

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 1

• Family Fare Pharmacy #647 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 4

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

• Kimberly A Markham, RPH

  • Pharmacist
  • Manistee, MI
  • NPI 1730451782
  NPD (past)
• Austin Andrew Olson

  • Pharmacist
  • Manistee, MI
  • NPI 1942180591
  NPD (past)
• Jenny Lyn Olson, RPH

  • Pharmacist
  • Manistee, MI
  • NPI 1922386721
  NPD (past)
• Heather Pearson, RPH

  • Pharmacist
  • Manistee, MI
  • NPI 1912502147
  NPD (past)

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

{
    "created_epoch": "1242864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785974400000",
    "number": "1245465111",
    "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": "1057 US HIGHWAY 31 S",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496602270",
            "telephone_number": "231-398-3202",
            "fax_number": "231-398-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVOS FAMILY MARKETS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-21",
        "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": "5301009135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2120728",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Fare Pharmacy #647",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Fare Pharmacy #647",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelli Lynne Pettit
• Tricia S Polcik
• Kimberly Anne Polcyn
• Joy Pomeroy, RN
• Ryan Poort
• Rachel N Price, NP
• Jessica Pringle
• Sheila Pritchard
• Jessica Radek
• Sharon Ramsay

• Community/Retail Pharmacy in Manistee, MI
• Providers in Manistee, 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.