Family Fare, LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

5301006962 Issued in MI

Legal business name

FAMILY FARE, LLC

Doing business as

Family Fare Pharmacy 1510

Practice address

829 W Main St
Gaylord, MI 49735-1998

Phone

(989) 732-4114

Fax

(989) 732-9514

NPI assigned

Sep 25, 2006

Last updated

Dec 7, 2023By the provider in NPPES

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 2

Other names 1

• FAMILY FARE PHARMACY 1510 Doing business as

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1306946637",
    "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": "829 W MAIN ST",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351998",
            "telephone_number": "989-732-4114",
            "fax_number": "989-732-9514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY FARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "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": "MI",
            "license": "5301006962",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4084635",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2343452",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY FARE PHARMACY 1510",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FAMILY FARE PHARMACY 1510",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Jett Ewing
• Family First Medicine PLLC (Becky L Ashley MD PLLC)
• Tricia Farkas
• Jacelyn M Fate, RN
• Jane Ferguson, PTA
• Krystle Ferguson, PHARMD

• Pharmacy in Gaylord, MI
• Providers in Gaylord, MI by specialty
• 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.