Organization
FREDS SUPER PHARMACY INC
Active
Other names
Freds Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FREDERICK WILLIAM NELSON RPH (PRESIDENT OWNER)
(269) 649-0660
Entity
Organization
Contact information
Practice address
131 N GRAND ST, SCHOOLCRAFT, MI 49087
(269) 679-4061
(269) 679-4621
Mailing address
PO BOX 396, 131 N GRAND ST, SCHOOLCRAFT, MI 49087-0396
(269) 679-4061
(269) 679-4621
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5301003028
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2529293
—
MI
Enumeration date
12/16/2005
Last updated
08/22/2020
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