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Organization
FREDS XPRESS
Active
Organization
FREDS XPRESS
Active
Other names
FREDS STORES OF TENNESSEE INC
Organization subpart
No
Provider details
NPI number
Authorized official
RICKY CHAMBERS (EXEC VP)
(901) 238-2477
Entity
Organization
Contact information
Practice address
305 FRONT ST, TAYLORSVILLE, MS 39168-0818
(601) 785-6812
(601) 785-4993
Mailing address
PO BOX 818, TAYLORSVILLE, MS 39168-0818
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
03081012
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2586785
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
04/03/2007
Last updated
08/22/2020
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