# FREDS STORES OF TENNESSEE INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FREDS INC
- **Other names:** Freds Pharmacy 3614
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1073814455
- **Legal business name:** FREDS INC
- **Authorized official:** DR. RICKY CHAMBERS PHARMD (VP)
- **Authorized official phone:** (901) 238-2477

## Contact information

- **Practice address:** 6129 CALHOUN MEMORIAL HWY STE C, EASLEY, SC 29640-3781
- **Practice address phone:** (864) 859-4077
- **Mailing address:** 4300 NEW GETWELL RD, MEMPHIS, TN 38118-6801
- **Mailing address phone:** (901) 238-2520

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 711226 | SC | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 11/16/2010
- **Last updated:** 08/09/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 711226 | — | SC |
| 01 | — | DE3370 | MEDICAID DME | SC |