# FREDS STORES OF TENNESSEE INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FREDS INC
- **Other names:** Freds Pharmacy 3648
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1093969016
- **Legal business name:** FREDS INC
- **Authorized official:** RICKY CHAMBERS PHARMD (VP)
- **Authorized official phone:** (901) 238-2477

## Contact information

- **Practice address:** 1221 E UNION ST, GREENVILLE, MS 38703-3243
- **Practice address phone:** (662) 332-3600
- **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 |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 03676/01.2 | MS | — |
| 3336C0003X | Community/Retail Pharmacy | 03676/01.2 | MS | Yes |

## Other

- **Enumeration date:** 11/05/2008
- **Last updated:** 03/16/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 08129798 | — | MS |
| 01 | — | 2587458 | NCPDP | — |