FREDS STORES OF TENNESSEE INC (NPI# 1225060254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225060254 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 3341 |
| Practice Address |
8515 Dollarway Rd White Hall AR 71602-2812 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 8702470026 |
| Practice Fax Number | 8702475807 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2010-01-04 |
| 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 | 420039 | AR | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
420039 | AR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 0420012 | 01 | |
| AR | DME | 155603716 | 01 |
| AR | 132167407 | 05 |
| Other Name | Type Code |
|---|---|
| FREDS PHARMACY 3341 | 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 |
8515 DOLLARWAY RD |
| City | WHITE HALL |
| State | AR |
| Zip Code | 71602-2812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841540804 | Larna J Davis | Pharmacist | 8515 Dollarway Rd, White Hall, AR 71602-2812 | 2012-09-17 |
| 1326475740 | Sally Kalkbrenner | Pharmacist | 8515 Dollarway Rd, White Hall, AR 71602-2812 | 2013-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265050447 | Bridget Furlong | Occupational Therapist | 2226 Barncy Lane, White Hall, AR 71602 | 2020-07-14 |
| 1609399963 | Interventional Surgery Institute of White Hall LLC | Clinic/Center | 7211 Dollarway Road, White Hall, AR 71602 | 2017-07-19 |
| 1679935761 | Pain Treatment Centers of America, Pllc | Durable Medical Equipment & Medical Supplies | 7211 Dollarway Rd, White Hall, AR 71602 | 2016-03-28 |
| 1326450446 | Rafeek Hegazy | Anesthesiology | 202 Frankie Ln, White Hall, AR 71602 | 2014-05-22 |
| 1275873515 | Craig Paul Anderson | Preventive Medicine | 13-020 Kabrich Circle, Pine Bluff, AR 71602 | 2013-02-24 |
| 1124258553 | Shellia Anne Kornegay | Nurse Practitioner | 1515 West 42nd Street, Pine Bluff, AR 71602 | 2009-07-20 |
| 1275789109 | Sarah Allison Rushing | Speech-Language Pathologist | 1020 West Holland Avenue, White Hall, AR 71602 | 2008-08-12 |
| 1245438852 | White Hall School District | Local Education Agency (LEA) | 1020 West Holland, White Hall, AR 71602 | 2007-07-05 |
| 1972622652 | Dewey Charles Scarbrough | Physician Assistant | 109 Frankie Lane, White Hall, AR 71602 | 2007-03-27 |
| 1427126135 | Donna D Massey | Dentist | 7215 Sheridan Road, White Hall, AR 71602 | 2006-12-01 |
| Find all providers in zip 71602 | ||||
| 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 |
|---|---|---|---|---|
| 1649740739 | Daily Dose Drugstore, Inc. | Pharmacy | 103 Timber Ln, White Hall, AR 71602-3331 | 2018-11-30 |
| 1962636829 | Whitehall Pharmacy LLC | Pharmacy | 1600 W Holland Ave Ste 101a, White Hall, AR 71602-9636 | 2009-05-07 |
| 1295078137 | Pharmacy Plus, Inc. | Pharmacy | 116 N Main St, White Hall, IL 62092-1054 | 2013-03-28 |
| 1447300926 | City Drug Inc. | Pharmacy | 116 N Main St, White Hall, IL 62092-1054 | 2007-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356942320 | Freda Cunningham | Pharmacy | 2100 Hwy 77, Marion, AR 72364 | 2020-11-05 |
| 1457978157 | Sc Pharmacy Group Opco LLC | Pharmacy | 1800 Riverfront Dr Ste 100, Little Rock, AR 72202-1882 | 2020-06-29 |
| 1790306124 | Jbr Enterprises Inc | Pharmacy | 600 Hwy 365, Mayflower, AR 72106 | 2020-04-27 |
| 1215557905 | Medman23, Inc | Pharmacy | 3201 Springhill Dr Ste 110, North Little Rock, AR 72117-2910 | 2020-04-22 |
| 1336768985 | Harps Food Stores, Inc | Pharmacy | 611 Highway 62 65 N, Harrison, AR 72601-2208 | 2020-04-14 |
| 1598393605 | Highlands Oncology Group Pa | Pharmacy | 3901 Parkway Circle, Springdale, AR 72762 | 2020-04-01 |
| 1326674870 | Caraway Drug L.l.c | Pharmacy | 106 W. State Street, Caraway, AR 72419 | 2020-03-17 |
| 1104461532 | Pruett's Food, Inc. | Pharmacy | 101 W. Main, Lockesburg, AR 71846 | 2019-11-08 |
| 1760025274 | Holiday Island Pharmacy, LLC | Pharmacy | 2 Forest Park Dr Ste A, Holiday Island, AR 72631-9229 | 2019-10-28 |
| 1730722463 | Beebe Family Pharmacy, LLC | Pharmacy | 1701 W Dewitt Henry Dr, Beebe, AR 72012-2024 | 2019-10-25 |
| Find all providers with the same taxonomy | ||||
| City | WHITE HALL |
| Zip Code | 71602 |
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.