FREDS STORES OF TENNESSEE INC (NPI# 1073545000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073545000 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 3366 |
| Practice Address |
1130 S Mccrary St Woodbury TN 37190-5997 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 6155638379 |
| Practice Fax Number | 6155632569 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2014-06-03 |
| Authorized Official Name | RICKY CHAMBERS (VP) |
| Authorized Official Telephone | 9012382477 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | Y |
| Parent Organization Name | FREDS INC |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | C3373 | TN | Suppliers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | C3373 | TN | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
C3373 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 4433099 | 01 |
| Other Name | Type Code |
|---|---|
| FREDS PHARMACY 3366 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427454511 | Freds Stores of Tennessee Inc | Pharmacy | 211 Three Oaks Drive, Medina, TN 38355 | 2014-11-17 |
| 1710383690 | Freds Stores of Tennessee Inc | Pharmacy | 810 Se Washington St, Idabel, OK 74745-3442 | 2014-11-05 |
| 1265836142 | Freds Stores of Tennessee Inc | Pharmacy | 1068 Highway 61 N., Tunica, MS 38676 | 2014-10-21 |
| 1740699958 | Freds Stores of Tennessee Inc | Pharmacy | 510 S. Thomson Avenue, Iowa, LA 70647 | 2014-08-13 |
| 1801207287 | Freds Stores of Tennessee Inc | Pharmacy | 988 Erwin Rd, Dunn, NC 28334-4526 | 2014-05-19 |
| 1205247681 | Freds Stores of Tennessee Inc | Pharmacy | 2311 E Morris St, Dalton, GA 30721-4373 | 2014-05-19 |
| 1861802134 | Freds Stores of Tennessee Inc | Pharmacy | 201 Walnut Street, Montezuma, GA 31063 | 2014-05-07 |
| 1851719199 | Freds Stores of Tennessee Inc | Pharmacy | 218 East M W Watson Blvd., Daingerfield, TX 75638-2038 | 2014-04-03 |
| 1942623889 | Freds Stores of Tennessee Inc | Pharmacy | 604 Northside Drive, Statesboro, GA 30458 | 2014-01-29 |
| 1972934263 | Freds Stores of Tennessee Inc | Pharmacy | 312 Main Street Hwy 19, Baker, LA 70714 | 2013-12-11 |
| Street Address |
1130 S MCCRARY ST |
| City | WOODBURY |
| State | TN |
| Zip Code | 37190-5997 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215245782 | Tim Akers | Pharmacist | 1130 S Mccrary St, Woodbury, TN 37190-5997 | 2010-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376143891 | Results-ast Jv, LLC | Physical Therapist | 324 Doolittle Road, Woodbury, TN 37190 | 2020-10-26 |
| 1255407219 | Catherine Lorraine Levi | Physical Therapy Assistant | 119 West High Street, Woodbury, TN 37190 | 2006-11-28 |
| 1669807830 | Heather J Melton | Nurse Practitioner | 89 Mears Drive, Woodbury, TN 37190 | 2013-09-06 |
| 1639245681 | James L Mayes | Physical Therapist | 324 Doolittle Rd, Woodbury, TN 37190 | 2006-11-28 |
| 1811063878 | Melisa Johnson Curtis | Physical Therapy Assistant | 324 Doolittle Rd, Stones River Hospital Inpatient Rehab, Woodbury, TN 37190 | 2006-11-28 |
| 1437677796 | Woodbury Drug Center LLC | Pharmacy | 604 W Main St, Woodbury, TN 37190-1029 | 2017-09-06 |
| 1437148905 | Darryl T Deason | Dentist | 801b W Main St, Woodbury, TN 37190-1032 | 2005-10-18 |
| 1629067855 | Andrew P Bucher | Dentist | 801b W Main St, Woodbury, TN 37190-1032 | 2005-10-20 |
| 1003360793 | Woodbury Dental Partners | Dentist | 801 W Main St, Suite B, Woodbury, TN 37190-1047 | 2016-08-10 |
| 1407000417 | Darryl T Deason | Dentist | 801 W Main St, Suite B, Woodbury, TN 37190-1047 | 2008-11-05 |
| Find all providers in zip 37190 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| 1790960458 | Linden Care LLC | Pharmacy | 130 Crossways Park Dr, Suite 101, Woodbury, NY 11797-2046 | 2007-12-31 |
| 1609953348 | Porter & Girgasky, Inc. | Pharmacy | 682 Main St S, Woodbury, CT 06798-3736 | 2006-11-01 |
| 1093820870 | Berat Corporation | Pharmacy | 1077 Mantua Pike, Woodbury, NJ 08096-3919 | 2006-08-20 |
| 1124040803 | Grand St Paul Cvs LLC | Pharmacy | 7200 Valley Creek Plz, Woodbury, MN 55125-2265 | 2006-07-24 |
| 1376561308 | Walgreen Co | Pharmacy | 1615 Queens Dr, Woodbury, MN 55125-1559 | 2006-07-17 |
| 1134184260 | Mary E Tyrrell | Pharmacy | 2 Main St N, Woodbury, CT 06798-2950 | 2006-04-20 |
| 1609975911 | Grand St Paul Cvs LLC | Pharmacy | 2150 Eagle Creek Ln, Woodbury, MN 55129-3201 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033718317 | Rockvegas Enterprises Inc Dba Gateway Pharmacy | Pharmacy | 524 N Gateway Ave, Rockwood, TN 37854-2353 | 2020-10-19 |
| 1124626767 | Knoxville Rx Corp | Pharmacy | 10205 Kingston Pike Ste E, Knoxville, TN 37922-3285 | 2020-10-15 |
| 1073126181 | Off Center, LLC | Pharmacy | 910 Overton Plz, Livingston, TN 38570-1753 | 2020-08-28 |
| 1316557937 | Guardian Pharmacy of Tennessee Three, LLC | Pharmacy | 661 E Lane St Ste B, Shelbyville, TN 37160-3437 | 2020-08-07 |
| 1447860507 | Fph LLC | Pharmacy | 2200 N Central Ave, Humbolt, TN 38343 | 2020-08-04 |
| 1366069965 | Plaza Pharmacy LLC | Pharmacy | 3024 Covington Pike Ste 5, Memphis, TN 38128-5043 | 2020-06-30 |
| 1548886104 | Tumlin Rx, LLC | Pharmacy | 104 E Main Blvd, Church Hill, TN 37642-3724 | 2020-06-19 |
| 1366065278 | Life Well Pharmacy, LLC | Pharmacy | 2408 Susannah St Ste 3, Johnson City, TN 37601-1765 | 2020-05-27 |
| 1699398602 | Walgreen Co | Pharmacy | 262 Danny Thomas Pl Ste 100rx, Memphis, TN 38105-3678 | 2020-05-26 |
| 1053931881 | Jones & Joslin, Pllc | Pharmacy | 4249 Highway 411 Ste 5, Madisonville, TN 37354-1544 | 2020-04-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.