Organization
FREDS STORES OF TENNESSEE INC
Active
Parent organization
FREDS INC
Other names
Freds Pharmacy 3648
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
1221 E UNION ST, GREENVILLE, MS 38703-3243
(662) 332-3600
Mailing address
4300 NEW GETWELL RD, MEMPHIS, TN 38118-6801
(901) 238-2520
(901) 365-9820
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
03676/01.2
MS
3336C0003X
Community/Retail Pharmacy
Primary
03676/01.2
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08129798
—
MS
01
—
2587458
NCPDP
—
Enumeration date
11/05/2008
Last updated
03/16/2009
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