MEDICARE: PREVO'S FAMILY MARKETS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy
2	333600000X	Pharmacy	5301007334	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2354316	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1932209269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREVO'S FAMILY MARKETS LLC

Provider Business Mailing Address
First Line	:	1527 MOMENTUM PL
Second Line	:	SPARTAN PHARMACY NORTH
City	:	CHICAGO
State	:	IL
Zip	:	60689-5315
Country	:	US
Telephone Number	:	616-878-8584
Fax Number	:

Provider Business Practice Location Address
First Line	:	4122 US31 SOUTH
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-9228
Country	:	US
Telephone Number	:	231-943-4017
Fax Number	:	231-943-3586

Authorized Official
Title or Position	:	DIRECTOR OF PHARMACY
Name	:	AMY ELLIS
Credential	:	RPH
Telephone Number	:	616-878-2848

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	10/31/2025

Similar Medicare Providers

1619251394 — CAMILLA WILLIAMS RPH
Practice Location Address:

4122 US HIGHWAY 31 S
TRAVERSE CITY, MI
49685-9228

Practice Phone: 231-943-4017
Practice Fax:

1376827840 — LAUREN KAY LEITNER R.PH.
Practice Location Address:

4122 US HIGHWAY 31 S
TRAVERSE CITY, MI
49685-9228

Practice Phone: 231-943-4017
Practice Fax: 231-943-3586

1386910446 — MARK R SUITOR R.PH.
Practice Location Address:

4144 US HIGHWAY 31 S
TRAVERSE CITY, MI
49685-9228

Practice Phone: 231-943-4017
Practice Fax:

1679081558 — DR. RYAN RICHARD FREYE PHARM.D.
Practice Location Address:

4122 US HIGHWAY 31 S
TRAVERSE CITY, MI
49685-9228

Practice Phone: 231-943-4017
Practice Fax: 231-943-3586

1104545557 — DR. KAYLA ORBAN PHARMD
Practice Location Address:

4122 US HIGHWAY 31 S
TRAVERSE CITY, MI
49685-9228

Practice Phone: 231-943-4017
Practice Fax: 231-943-3586

1912429887 — JESSE STOKES LLOYD NP
Practice Location Address:

3385 W 2525 N
PLAIN CITY, UT
84404-9228

Practice Phone: 801-644-5121
Practice Fax:

Directions to “PREVO'S FAMILY MARKETS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.