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Organization
FREDS STORES OF TENNESSEE INC
Active
Organization
FREDS STORES OF TENNESSEE INC
Active
Other names
FREDS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX KNIGHT (DIR OF THIRD PARTY OPERATIONS)
(901) 238-3625
Entity
Organization
Contact information
Practice address
511 18TH AVE N, COLUMBUS, MS 39705-2215
(662) 327-7349
(662) 327-7492
Mailing address
511 18TH AVE N, COLUMBUS, MS 39705-2215
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5941012
MS
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07989206
—
MS
01
—
2521498
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/07/2006
Last updated
09/11/2025
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