MEDICARE: FAMILY FARE, 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	5301008229	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2369064	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1841359841
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY FARE, 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	:	1415 FULTON ST E
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49503-3853
Country	:	US
Telephone Number	:	616-774-9422
Fax Number	:	616-774-9380

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

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	12/07/2023

Similar Medicare Providers

1396715223 — TIMOTHY BOUWKAMP RPH
Practice Location Address:

1415 FULTON ST E
GRAND RAPIDS, MI
49503-3853

Practice Phone: 616-774-9422
Practice Fax: 616-774-9380

1750353660 — MR. RAJNI C PATEL RPH
Practice Location Address:

1415 E FULTON ST
GRAND RAPIDS, MI
49503-3853

Practice Phone: 616-774-9422
Practice Fax: 616-774-9380

1730655978 — DR. BRIAN WHEATON PHARMD
Practice Location Address:

1415 FULTON ST E
GRAND RAPIDS, MI
49503-3853

Practice Phone: 616-774-9422
Practice Fax:

1306972930 — MS. CHRISTINE LYNN WILLIAMSON LMFT
Practice Location Address:

4740 N GRAND AVE
COVINA, CA
91724-3853

Practice Phone: 626-859-2089
Practice Fax: 626-859-6537

1003602566 — TOSHA BELL NASM-CPT, NASM-WFS
Practice Location Address:

2304 BARDIN RD STE 200
GRAND PRAIRIE, TX
75052-3853

Practice Phone: 214-892-7454
Practice Fax:

1962988030 — LISA R BAKER LCMS, BC-TMH
Practice Location Address:

1115 ALTO AVE SE
GRAND RAPIDS, MI
49507-1403

Practice Phone: 616-443-3853
Practice Fax:

Directions to “FAMILY FARE, 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.