FREDS STORES OF TENNESSEE INC (NPI# 1104842772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104842772 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 1441 |
| Practice Address |
1560 Donelson Pkwy Dover TN 37058-3731 |
| Mailing Address |
6625 Lenox Park Blvd. Suite 200 Memphis TN 38115 |
| Practice Telephone | 9312325096 |
| Practice Fax Number | 9312324921 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2019-08-30 |
| Authorized Official Name | JOSEPH ANTO (CEO) |
| Authorized Official Telephone | 9013623733 |
| Is Organization Subpart | Y |
| Parent Organization Name | FREDS INC |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | C3259 | TN | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
C3259 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 4431514 | 01 |
| Other Name | Type Code |
|---|---|
| FREDS PHARMACY 1441 | 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 |
1560 DONELSON PKWY |
| City | DOVER |
| State | TN |
| Zip Code | 37058-3731 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184969941 | Ashley Clendenen | Pharmacist | 1560 Donelson Pkwy, Pob 127, Dover, TN 37058-3731 | 2012-12-05 |
| 1215452321 | James Thomas Pokorny IIi | Pharmacist | 1560 Donelson Pkwy, Dover, TN 37058-3731 | 2017-08-09 |
| 1184165920 | Bryce Neblett | Pharmacist | 1560 Donelson Pkwy, Dover, TN 37058-3731 | 2017-03-13 |
| 1467803502 | Emily Taylor | Pharmacist | 1560 Donelson Pkwy, Dover, TN 37058-3731 | 2016-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023474681 | Rebecca Cravens | Nurse Practitioner | 1511 Donelson Parkway, Dover, TN 37058 | 2016-01-12 |
| 1487894028 | Joselito A Pasaol | Physical Therapist | 402 C Church Street, Dover, TN 37058 | 2009-02-23 |
| 1588809461 | Lakeway Physical Therapy Outpatient, Pllc | Clinic/Center | 402-c Church St., Dover, TN 37058 | 2008-12-08 |
| 1225212350 | Dana M. Earhart | Licensed Practical Nurse | 723 Spring Street, Attn. Dana Earhart, School Nurse, Dover, TN 37058 | 2007-12-26 |
| 1437333614 | Tammy Lagan | Occupational Therapist | 949 Hwy 79, Dover, TN 37058 | 2007-12-24 |
| 1649390956 | Beverly Lynn Lewis | Audiologist | Lewis Hearing Services, 407 A Hwy. 79, Dover, TN 37058 | 2007-03-30 |
| 1689640898 | Price Edwin Hopson Jr. | Dentist | 1021 Spring St, Dover, TN 37058 | 2006-02-27 |
| 1154801207 | Crystal Lynn Shaw | Nurse Practitioner | 1511 Donelson Pkwy, Dover, TN 37058 | 2018-08-17 |
| 1235630112 | Elizabeth Amelia Estock | Registered Nurse | 1021 Spring St, Dover, TN 37058 | 2018-02-26 |
| 1740793736 | Mei-suey Chen | Internal Medicine | 314 Cedar St, Dover, TN 37058 | 2017-11-13 |
| Find all providers in zip 37058 | ||||
| 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 |
|---|---|---|---|---|
| 1548363369 | Ohio Cvs Stores LLC | Pharmacy | 300 Oxford St, Dover, OH 44622-1963 | 2006-09-07 |
| 1588776587 | Neil-kavita Pharmacy Inc | Pharmacy | 233 E Mcfarlan St, Dover, NJ 07801-3603 | 2006-08-31 |
| 1376553883 | Suncoast Community Health Center Inc | Pharmacy | 14254 Sr 574 Bvld, Dover, FL 33527 | 2006-08-08 |
| 1295753275 | Walgreen Co. | Pharmacy | 5506 S Dupont Hwy, Dover, DE 19901-6410 | 2006-07-17 |
| 1720061591 | Neidig Health Care, Ltd | Pharmacy | 710 Boulevard St, Dover, OH 44622-2006 | 2005-11-24 |
| 1023316700 | The Union Hospital Association | Pharmacy | 659 Boulevard St, Dover, OH 44622-2026 | 2011-03-04 |
| 1255438453 | Direct Meds of Dover | Pharmacy | 400 W Blackwell St, Dover, NJ 07801-2525 | 2006-09-20 |
| 1508970393 | Rose Drug of Dover Inc | Pharmacy | 8880 Market St, Pob 335, Dover, AR 72837-9111 | 2006-08-18 |
| 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.