Organization
FREDS STORES OF TENNESSEE INC
Active
Parent organization
FREDS INC
Other names
FREDS XPRESS 3861
Organization subpart
Yes
Provider details
NPI number
Legal business name
FREDS INC
Authorized official
RAHUL KUL KARNI (SVP OF FINANCE)
(800) 374-7417
Entity
Organization
Contact information
Practice address
705 PLANK ROAD HWY 128, ST. JOSEPH, LA 71366
(318) 766-4563
(318) 766-4522
Mailing address
6625 LENOX PARK BLVD., SUITE 200, MEMPHIS, TN 38115
(901) 238-2520
(901) 365-9820
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5000
LA
3336C0003X
Community/Retail Pharmacy
Primary
5000
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1269743
—
LA
01
—
1930850
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/17/2006
Last updated
12/05/2019
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