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Organization

FREDS STORES OF TENNESSEE INC

Active
Parent organization
FREDS INC
Other names
FREDS XPRESS 3516
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
25 MAIN STREET, BROOKESVILLE, MS 39739
(662) 738-5878
(662) 738-4888
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
5847012
MS
3336C0003X
Community/Retail Pharmacy
Primary
5847012
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2521359
OTHER ID NUMBER-COMMERCIAL NUMBER
05
6301716
MS
Enumeration date
07/17/2006
Last updated
12/04/2007
About Stedi
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  • Eligibility checks
  • EDI platform