Organization
FREDS STORES OF TENNESSEE INC
Active
Parent organization
FREDS INC
Other names
Freds Pharmacy 3608
Organization subpart
Yes
Provider details
NPI number
Legal business name
FREDS INC
Authorized official
DR. RICKY CHAMBERS PHARMD (VP)
(901) 238-2477
Entity
Organization
Contact information
Practice address
101 W MAIN ST, EASLEY, SC 29640-2038
(864) 859-4015
Mailing address
4300 NEW GETWELL RD, MEMPHIS, TN 38118-6801
(901) 238-2520
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
711227
SC
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
711227
—
SC
01
—
DE3394
MEDICAID DME
SC
Enumeration date
11/24/2010
Last updated
08/09/2011
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