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Organization

FREDS STORES OF TENNESSEE INC

Active
Parent organization
FREDS INC
Other names
FREDS PHARMACY 1836
Organization subpart
Yes

Provider details

NPI number
Legal business name
FREDS INC
Authorized official
RICKY CHAMBERS PHARMD (VP)
(901) 238-2477
Entity
Organization

Contact information

Practice address
140 TRADE CENTER LN, HAZLEHURST, MS 39083-2319
(601) 894-3008
(601) 894-4864
Mailing address
4300 NEW GETWELL RD, MEMPHIS, TN 38118-6801
(901) 238-2520
(901) 365-9820

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
23641FH
MS
3336C0003X
Community/Retail Pharmacy
Primary
23641FH
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05776723
MS
01
2517413
OTHER ID NUMBER-COMMERCIAL NUMBER
Enumeration date
07/07/2006
Last updated
11/29/2007
About Stedi
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  • Eligibility checks
  • EDI platform