# PAYLESS AT FRED'S INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Payless at Freds
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912355231
- **Authorized official:** NICK W HOLLAND AUTHORIZED OFFICIAL (OWNER)
- **Authorized official phone:** (256) 423-2680

## Contact information

- **Practice address:** 29930 ARDMORE AVENUE, ARDMORE, AL 35739-7450
- **Practice address phone:** (256) 423-8989
- **Practice address fax:** (256) 423-8990
- **Mailing address:** P.O. BOX 566, ARDMORE, TN 38449-0429
- **Mailing address phone:** (256) 423-8969
- **Mailing address fax:** (256) 423-8990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 110617 | AL | Yes |

## Other

- **Enumeration date:** 05/26/2016
- **Last updated:** 05/26/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100002271 | — | AL |