Organization
FREDS STORES OF TENNESSEE INC
Active
Other names
FREDS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX KNIGHT (DIR OF THIRD PARTY OPERATIONS)
(901) 238-3625
Entity
Organization
Contact information
Practice address
260 KEEN STREET, BURKESVILLE, KY 42717
(270) 864-1772
(270) 864-5981
Mailing address
260 KEEN STREET, BURKESVILLE, KY 42717
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
P06773
KY
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1827356
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
54003546
—
KY
Enumeration date
07/17/2006
Last updated
09/11/2025
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