Organization
FREDS STORES OF TENNESSEE INC
Active
Parent organization
FREDS INC
Other names
FREDS PHARMACY 2229
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
11299 HIGHWAY 63 S, LUCEDALE, MS 39452-6617
(601) 947-8105
(601) 947-1141
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
5031012
MS
3336C0003X
Community/Retail Pharmacy
Primary
5031012
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0330605
—
MS
01
—
2520458
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/07/2006
Last updated
04/30/2012
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