FREDS STORES OF TENNESSEE INC (NPI# 1164450128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164450128 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 2304 |
| Practice Address |
1105 Warm Springs Hwy Manchester GA 31816-1167 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 7068462776 |
| Practice Fax Number | 7068462712 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2008-01-11 |
| 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 | 333600000X | Pharmacy | PHRE008795 | GA | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE008795 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1151567 | 01 |
| Other Name | Type Code |
|---|---|
| FREDS PHARMACY 2304 | 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 |
1105 WARM SPRINGS HWY |
| City | MANCHESTER |
| State | GA |
| Zip Code | 31816-1167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326338344 | Edward T Rocereta | Pharmacist | 1105 Warm Springs Hwy, Manchester, GA 31816-1167 | 2011-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184987935 | Clyde Copeland | Driver | 5465 Scenic Hts, Manchester, GA 31816 | 2012-06-18 |
| 1417129081 | Fuller Life Chiropractic Center PC | Chiropractor | 23 East Main St, Manchester, GA 31816 | 2008-03-24 |
| 1861694374 | Richard L Ousley Dds PC | Dentist | 404 West Perry Street, Manchester, GA 31816 | 2007-06-05 |
| 1558424093 | Fuller Life Chiropractic Center | Chiropractor | 23 East Main Street, Manchester, GA 31816 | 2006-12-18 |
| 1174980262 | Mortar & Pestle, LLC | Pharmacy | 1194 Warm Springs Hwy, Manchester, GA 31816 | 2016-01-21 |
| 1942616008 | Candice Renee Gaultney | Massage Therapist | 102 W 2nd St, Manchester, GA 31816 | 2014-07-09 |
| 1942586607 | Fuller Life Solutions | Chiropractor | 23 E Main St, Manchester, GA 31816 | 2011-10-26 |
| 1750419446 | Beckhams Hhc Pharmacy Inc | Pharmacist | 1194 Warm Springs Hwy, Manchester, GA 31816-1166 | 2007-03-02 |
| 1326006222 | Clemson Sports Medicine and Rehabilitation, Inc | Clinic/Center | 1140 Warm Springs Hwy, Manchester, GA 31816-1166 | 2006-05-02 |
| 1942296017 | Allan William Moore | Optometrist | 1180 Warm Springs Hwy, Manchester, GA 31816-1166 | 2005-09-23 |
| Find all providers in zip 31816 | ||||
| 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 |
|---|---|---|---|---|
| 1043776768 | Jdl Consulting LLC | Pharmacy | 118 Clay County Shopping Ctr, Manchester, KY 40962-1299 | 2019-02-18 |
| 1104291707 | Manchester Pharmacy & Medical | Pharmacy | 4310 N George Street Ext, Manchester, PA 17345-1307 | 2015-12-08 |
| 1457693822 | Morgans Professional Pharmacy LLC | Pharmacy | 280 Richmond Rd, Manchester, KY 40962-1209 | 2013-03-22 |
| 1740525773 | Clay Community Pharmacy LLC | Pharmacy | 118 Clay Co S/c, Manchester, KY 40962 | 2012-12-03 |
| 1447557632 | Qualicare Pharmacy LLC | Pharmacy | 342 Main St., Manchester, CT 06040 | 2011-02-24 |
| 1871676130 | Cvs Manchester Nh, L.L.C. | Pharmacy | 271 Mammoth Rd, Manchester, NH 03109-4124 | 2006-10-23 |
| 1063595320 | Cvs Manchester Nh LLC | Pharmacy | 788 S Willow St, Manchester, NH 03103-4018 | 2006-10-23 |
| 1245325844 | Blake Pharmacy, Inc. | Pharmacy | 35 E Second St, Manchester, OH 45144-1301 | 2006-10-03 |
| 1881787257 | Southern Family Markets LLC | Pharmacy | 2050 Hillsboro Blvd, Manchester, TN 37355-7306 | 2006-09-30 |
| 1033743109 | Manchester Prescription Center, LLC | Pharmacy | 1668 S Highway 421, Manchester, KY 40962-7514 | 2020-02-27 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 31816 |
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.