Active NPI
Prevos Family Markets LLC
- Community/Retail Pharmacy
- Rockford, MI
National Provider Identifier
1750440855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 5301008231
- Legal business name
- PREVOS FAMILY MARKETS LLC
- Practice address
- 201 Marcell Dr NE
Rockford, MI 49341-1364 - Phone
- (616) 863-9376
- Fax
- (616) 863-9402
- NPI assigned
- Dec 6, 2006
- 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 |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 5301008231 | MI | Primary |
Addresses
Primary practice location
201 Marcell Dr NE
Rockford, MI 49341-1364
Mailing address
1527 Momentum PL
Spartan Pharmacy North
Chicago, IL 60689-5315
Phone (616) 878-9594
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2368985 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- FAMILY FARE PHARMACY #1572
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D2084452 | Family Fare Pharmacy #1572 | Certificate of waiver | Sep 23, 2026 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Rockford, MI
- NPI 1194321273
-
- Pharmacist
- Rockford, MI
- NPI 1407614274
-
- Pharmacist
- Rockford, MI
- NPI 1912987470
-
- Pharmacist
- Rockford, MI
- NPI 1396717336
-
- Pharmacist
- Rockford, MI
- NPI 1386577526
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1785974400000",
"number": "1750440855",
"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": "616-878-9594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 MARCELL DR NE",
"city": "ROCKFORD",
"state": "MI",
"postal_code": "493411364",
"telephone_number": "616-863-9376",
"fax_number": "616-863-9402"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREVOS FAMILY MARKETS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-06",
"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": "5301008231",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "2368985",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "FAMILY FARE PHARMACY #1572",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Rockford, MI
Sources for this page
- 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.