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FAMILY FARE LLC NPI 1114027448


NPI Information

NPI: 1114027448
Provider Name: FAMILY FARE, LLC

Doing Business As: FAMILY FARE PHARMACY 254

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 23D2084477

Address:
1225 LEONARD ST NE
GRAND RAPIDS, MI
ZIP 49505
Phone: (616) 459-6203
Get Directions

FAMILY FARE, LLC is a pharmacy in Grand Rapids, MI. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. FAMILY FARE, LLC NPI is 1114027448. The provider is registered as an organization entity type.
The provider Is Doing Business As Family Fare Pharmacy 254.

The provider's business location address is:

1225 LEONARD ST NE
GRAND RAPIDS, MI
ZIP 49505-510
Phone: (616) 459-6203
Fax: (616) 454-8777

The provider's authorized official is Eddie Garcia .
The authorized official title is Director Of Pharmacy and has the following contact phone number (616) 878-2975.

The CLIA number assigned to this NPI record is 23D2084477 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/25/2006 and was last updated on 2/6/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacy5301006943MICHIGANYes
23336C0003XPharmacyCommunity/Retail PharmacyNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12353340OTHERMICHIGANNCPDP
21114027448OTHERMICHIGANNPI
34075485OTHERMICHIGANMI-DME
44473890003MEDICARE NSCMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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