Organization
FREDS STORES OF TENNESSEE INC
Active
Parent organization
FREDS INC
Other names
FREDS XPRESS 3926
Organization subpart
Yes
Provider details
NPI number
Legal business name
FREDS INC
Authorized official
RAHUL KULKARNI (SVP OF FINANCE)
(800) 374-7417
Entity
Organization
Contact information
Practice address
101 W SWEET POTATO ST, VARDAMAN, MS 38878-9433
(662) 682-7489
(662) 682-9132
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
0403301FV
MS
3336C0003X
Community/Retail Pharmacy
Primary
0403301FV
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0330357
—
MS
01
—
2519099
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/17/2006
Last updated
12/06/2019
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