# FREDS STORES OF TENNESSEE INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FREDS INC
- **Other names:** FREDS PHARMACY 1204
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1003848946
- **Legal business name:** FREDS INC
- **Authorized official:** RICKY CHAMBERS PHARMD (VP)
- **Authorized official phone:** (901) 238-2477

## Contact information

- **Practice address:** 330 W CHURCH ST, BATESBURG-LEESVILLE, SC 29006-2002
- **Practice address phone:** (803) 532-0293
- **Practice address fax:** (803) 532-7307
- **Mailing address:** 4300 NEW GETWELL RD, MEMPHIS, TN 38118-6801
- **Mailing address phone:** (901) 238-2520
- **Mailing address fax:** (901) 365-9820

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 50007912 | SC | — |
| 3336C0003X | Community/Retail Pharmacy | 50007912 | SC | Yes |

## Other

- **Enumeration date:** 07/07/2006
- **Last updated:** 01/11/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4225416 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |