FREDS STORES OF TENNESSEE INC (NPI# 1093969016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093969016 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 3648 |
| Practice Address |
1221 E Union St Greenville MS 38703-3243 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 6623323600 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2009-03-16 |
| Authorized Official Name | RICKY CHAMBERS (VP) |
| Authorized Official Telephone | 9012382477 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | Y |
| Parent Organization Name | FREDS INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 03676/01.2 | MS | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
03676/01.2 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP | 2587458 | 01 | |
| MS | 08129798 | 05 |
| Other Name | Type Code |
|---|---|
| Freds Pharmacy 3648 | 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 |
1221 E UNION ST |
| City | GREENVILLE |
| State | MS |
| Zip Code | 38703-3243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245394501 | Washington County Ltc, Inc. | Skilled Nursing Facility | 1221 E Union St, Greenville, MS 38703-3243 | 2006-12-21 |
| 1437284437 | Ricky B Smith | Pharmacist | 1221 E Union St, Greenville, MS 38703-3243 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164031373 | Rohith Reddy Guduru Venkata | Family Medicine | Delta Regional Medical Center, 1400 E Union St, Greenville, MS 38703 | 2020-07-24 |
| 1720627599 | Ava Seniors Academy LLC | Clinic/Center | 2425 E. Alexander Street, Greenville, MS 38703 | 2019-12-27 |
| 1902370661 | River City Rehabilitation | Physical Therapy Assistant | 1707 South Colorado Suite A, Greenville, MS 38703 | 2019-01-16 |
| 1942743653 | Jalisa R Greer | Speech-Language Pathologist | 1462 S Colorado Street, Apt 2g, Greenville, MS 38703 | 2016-11-29 |
| 1912381609 | Mvp Health Systems | Pharmacy | 1907 N. Medical Park Drive, Greenville, MS 38703 | 2015-07-13 |
| 1558704387 | Joann Wilson | Driver | 1766 Old Leland Rd, Greenville, MS 38703 | 2013-04-11 |
| 1215167150 | Luther Brandon Oakes | Family Medicine | 1907 Lisa Drive Ext, Greenville, MS 38703 | 2009-07-24 |
| 1346462751 | Drs Lenoir and Cirilli Pa | Internal Medicine | 1307 East Union, Greenville, MS 38703 | 2007-05-03 |
| 1669598561 | Michael Joseph Cirilli | Internal Medicine | 1307 E Union, Doctors Lenoir & Cirilli Pa, Greenville, MS 38703 | 2007-03-22 |
| 1780740183 | Jean Marie Barker | Family Medicine | 1659 East Union Street, Greenville, MS 38703 | 2006-12-29 |
| Find all providers in zip 38703 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275159758 | Hunt's Pharma Rx LLC | Pharmacy | 2934 W Interstate 30, Suite A, Greenville, TX 75402 | 2020-06-22 |
| 1912539818 | Greenville Pharmacy LLC | Pharmacy | 4209 Wesley St, Greenville, TX 75401-5637 | 2020-02-08 |
| 1285198283 | Pitt County Memorial Hospital Inc | Pharmacy | 2100 Stantonsburg Rd Rm 1ph-160, Greenville, NC 27834-2818 | 2019-01-24 |
| 1346713658 | Europa Enterprise LLC | Pharmacy | 2394 W Interstate 30 Ste A, Greenville, TX 75402 | 2019-01-09 |
| 1982173126 | Levee Drugs Inc | Pharmacy | 202 E Starling St # 1, Greenville, MS 38701-4707 | 2018-11-16 |
| 1326522376 | Piney Mountain Rx LLC | Pharmacy | 2498 North Pleasantburg Drive, Suite A, Greenville, SC 29609 | 2018-09-17 |
| 1184127102 | Snyder Partners, LLC | Pharmacy | 4000 Wesley St Ste G, Greenville, TX 75401-9015 | 2018-03-15 |
| 1508382839 | Mrvm LLC | Pharmacy | 1701 Augusta St, Greenville, SC 29605-2925 | 2017-08-18 |
| 1992228902 | Walgreen Co | Pharmacy | 2616 Anderson Rd, Greenville, SC 29611-6020 | 2017-07-21 |
| 1659739118 | Meiya LLC | Pharmacy | 543 Haywood Rd Ste 4, Greenville, SC 29607-2710 | 2016-01-29 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 38703 |
Please comment or provide details below to improve the information on FREDS STORES OF TENNESSEE INC.
| 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.