Organization
FREDS STORES OF TENNESSEE INC
Active
Parent organization
FREDS INC
Other names
FREDS PHARMACY 1839
Organization subpart
Yes
Provider details
NPI number
Legal business name
FREDS INC
Authorized official
MR. RICKY CHAMBERS PHARMD (VP)
(901) 238-2477
Entity
Organization
Contact information
Practice address
80 OAK STREET, HAMPTON, GA 30228
(770) 946-3901
(770) 946-3904
Mailing address
4300 NEW GETWELL RD, MEMPHIS, TN 38118-6801
(901) 238-2520
(901) 365-9820
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009116
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000367485F
—
GA
01
—
1155185
NCPDP
—
Enumeration date
01/19/2007
Last updated
05/08/2013
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