Organization
FREDS STORES OF TENNESSEE INC
Active
Parent organization
FREDS INC
Other names
Freds Pharmacy 1199
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
214 GA HIGHWAY 49 S, BYRON, GA 31008-6937
(478) 956-0478
(478) 956-0281
Mailing address
214 GA HIGHWAY 49 S, BYRON, GA 31008-6937
(478) 956-0478
(478) 956-0281
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PHRE009661
GA
3336C0003X
Community/Retail Pharmacy
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003101336A
—
GA
Enumeration date
04/27/2010
Last updated
08/09/2011
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