<Unavail>

LBN: Family Fare, Llc
<Unavail> is an health care organization with primary practice located at 1185 Washington Ave , Holland MI 49423-7729. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Family Fare, Llc can be contacted via phone (616) 392-7504, or through Ellis, Amy via phone (616) 878-2848.

Contact Information

Primary practice address
1185 Washington Ave Holland MI 49423-7729
Phone: (616) 392-7504
Fax: (616) 392-8021
Website:
Map and Directions
Authorized official contact:
Name: Ellis, Amy
Phone: (616) 878-2848

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 5301006944 Michigan
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1023118353
LBN Legal business name Family Fare, Llc
DBA Doing business as <Unavail>
Authorized official Ellis, Amy
Entity Organization
Organization subpart 1 No
Enumeration date Sep 25th, 2006
Last updated Dec 7th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023118353 NPPES
Michigan MEDICAID 4075494
Michigan Other 2354277

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