NPIMap

Organization Active NPI

Family Fare LLC

  • Community/Retail Pharmacy
  • Grand Rapids, MI
National Provider Identifier
1780928473
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301009024 Issued in MI
Legal business name
FAMILY FARE LLC
Practice address
4668 Cascade Rd SE
Grand Rapids, MI 49546-3718
Phone
(616) 949-0170
Fax
(616) 949-4073
NPI assigned
Nov 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 5301009024 MI
Community/Retail Pharmacy 3336C0003X 5301009024 MI Primary

Addresses

Primary practice location

4668 Cascade Rd SE
Grand Rapids, MI 49546-3718

Mailing address

1527 Momentum Place
Chicago, IL 60689-5315
Phone (616) 878-8584

Other names 1

  • FAMILY FARE - FOREST HILLS PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Fare LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

850 76th St SW
#761120
Byron Center, MI 49315

4668 Cascade Rd SE
Grand Rapids, MI 49546
Phone (616) 949-0170

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1780928473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 MOMENTUM PLACE",
            "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": "4668 CASCADE RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463718",
            "telephone_number": "616-949-0170",
            "fax_number": "616-949-4073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY FARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "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": "5301009024",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY FARE - FOREST HILLS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FAMILY FARE - FOREST HILLS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • 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.