Organization
FREDS PHARMACY OF QUITMAN LLC
Active
Parent organization
FREDS PHARMACY OF QUITMAN LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FREDS PHARMACY OF QUITMAN LLC
Authorized official
RICK CHAMBERS (VICE PRESIDENT)
(901) 238-2477
Entity
Organization
Contact information
Practice address
1123 WASHINGTON ST, VICKSBURG, MS 39183-2959
(601) 636-2756
Mailing address
PO BOX 5105, MERIDIAN, MS 39302-5105
(601) 693-2655
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04807541
—
MS
Enumeration date
04/03/2012
Last updated
09/18/2012
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