# FREDS XPRESS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FREDS STORES OF TENNESSEE INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730200114
- **Authorized official:** RICKY CHAMBERS (EXEC VP)
- **Authorized official phone:** (901) 238-2477

## Contact information

- **Practice address:** 305 FRONT ST, TAYLORSVILLE, MS 39168-0818
- **Practice address phone:** (601) 785-6812
- **Practice address fax:** (601) 785-4993
- **Mailing address:** PO BOX 818, TAYLORSVILLE, MS 39168-0818

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 03081012 | MS | Yes |

## Other

- **Enumeration date:** 04/03/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2586785 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |