Organization
FREDS STORES OF TENNESSEE INC
Active
Parent organization
FREDS INC
Other names
FREDS PHARMACY 3276
Organization subpart
Yes
Provider details
NPI number
Legal business name
FREDS INC
Authorized official
RICKY CHAMBERS PHARMD (VP)
(901) 365-9820
Entity
Organization
Contact information
Practice address
515 W MAIN ST STE A, WAVERLY, TN 37185-1406
(931) 296-2351
(931) 296-2388
Mailing address
4300 NEW GETWELL RD, MEMPHIS, TN 38118-6801
(901) 238-2520
(901) 365-9820
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
C3400
TN
333600000X
Pharmacy
C3400
TN
3336C0003X
Community/Retail Pharmacy
Primary
C3400
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4433190
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/07/2006
Last updated
09/18/2009
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