Family Fare, LLC
Organization Active NPI Pharmacy · Kalkaska, MI
NPI 1497855720 · NPPES record last updated Dec 7, 2023
Key facts
- NPI
- 1497855720
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 5301006968 (MI)
- Legal business name
- FAMILY FARE, LLC
- Practice address
- 784 S Cedar St
Kalkaska, MI 49646-9460 - Phone
- (231) 258-8681
- Fax
- (231) 258-4464
- NPI assigned
- Sep 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Amy Ellis
- Title
- Director of Pharmacy
- Phone
- (616) 878-2848
Practitioners 1
-
Jamie Lea Downer, PHARMD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D2084438 | Family Fare Pharmacy #1513 | Certificate of waiver | Sep 23, 2026 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 5301006968 | MI | Yes |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
784 S Cedar St
Kalkaska, MI 49646-9460
Mailing address
1527 Momentum PL
Spartan Pharmacy North
Chicago, IL 60689-5315
Phone (616) 878-8584
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497855720 | Other | MI | NPI |
| 4084770 | Other | MI | MI-DME |
| 2342979 | Other | MI | NCPDP |
Other names
- FAMILY FARE PHARMACY 1513
Other providers in Kalkaska, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.