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Organization
FREDS STORES OF TENNESSEE INC
Active
Organization
FREDS STORES OF TENNESSEE INC
Active
Parent organization
FREDS INC
Other names
FREDS XPRESS 3936
Organization subpart
Yes
Provider details
NPI number
Legal business name
FREDS INC
Authorized official
RICKY CHAMBERS PHARMD (VP)
(901) 238-2477
Entity
Organization
Contact information
Practice address
502 W SAINT LOUIS ST, WEST FRANKFORT, IL 62896-1957
(618) 932-3011
(618) 932-8401
Mailing address
4300 NEW GETWELL RD, MEMPHIS, TN 38118-6801
(901) 238-2520
(901) 365-9820
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
54014937
IL
3336C0003X
Community/Retail Pharmacy
Primary
54014937
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1475816
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/07/2006
Last updated
11/05/2012
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