FREDS STORES OF TENNESSEE INC (NPI# 1265836142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265836142 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY #3604 |
| Practice Address |
1068 Highway 61 N. Tunica MS 38676 |
| Mailing Address |
6625 Lenox Park Blvd. Suite 200 Memphis TN 38115 |
| Practice Telephone | 6623631540 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2019-12-05 |
| Authorized Official Name | RAHUL KULKARNI (SVP OF FINANCE) |
| Authorized Official Telephone | 8003747417 |
| Is Organization Subpart | Y |
| Parent Organization Name | FREDS INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 05638737 | 05 |
| Other Name | Type Code |
|---|---|
| Freds Pharmacy #3604 | 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 |
| 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 |
| 1396176095 | Freds Stores of Tennessee Inc | Pharmacy | 93 Bushrod Johnson Ave, Chickamauga, GA 30707-6093 | 2013-12-05 |
| Street Address |
1068 HIGHWAY 61 N. |
| City | TUNICA |
| State | MS |
| Zip Code | 38676 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255940615 | Bernude Jesucat | Speech-Language Pathologist | 1024 Us-61, Tunica, MS 38676 | 2020-07-30 |
| 1588215040 | Scpg Mississippi LLC | Pharmacy | 1068 Hwy 61 N, Tunica, MS 38676 | 2019-09-26 |
| 1316278328 | Delta House Calls | Nurse Practitioner | 2073 Old Hwy 61 North, Suite # 2, Tunica, MS 38676 | 2010-01-15 |
| 1104074228 | Ebenezer Home Care LLC | Homemaker | 1189 Main St, Tunicia, MS 38676 | 2008-09-03 |
| 1639356611 | Vincent H Copeland | Dentist | 1040 Highway 61 South, Tunica, MS 38676 | 2008-01-22 |
| 1609063742 | Phillip Parker | Counselor | 1459 Main St., Tunica, MS 38676 | 2007-10-03 |
| 1245360148 | Tunica County Healthcare Authority | Family Medicine | 1813 U. S. Highway 61 North, Tunica, MS 38676 | 2007-03-07 |
| 1780749739 | Tunica Quality Drugs, Inc | Pharmacy | 1068 Highway 61 N, Tunica, MS 38676 | 2006-12-27 |
| 1073625760 | Rcg Tunica, LLC | Clinic/Center | 1821 U.S. Hwy. 61 North, Tunica, MS 38676 | 2006-08-31 |
| 1538120258 | Preventive Care Health Services LLC | Nurse Practitioner | 2073 Old Highway 61 N, Ste#2, Tunica, MS 38676 | 2006-03-31 |
| Find all providers in zip 38676 | ||||
| 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 |
|---|---|---|---|---|
| 1588215040 | Scpg Mississippi LLC | Pharmacy | 1068 Hwy 61 N, Tunica, MS 38676 | 2019-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164038485 | Quinn's Family Pharmacy of Newton | Pharmacy | 193 Northside Dr, Newton, MS 39345-9523 | 2020-09-22 |
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1649883844 | Natchez Wellness Pharmacy | Pharmacy | 29 Sergeant Prentiss Dr Ste 5, Natchez, MS 39120-4743 | 2020-08-26 |
| 1952910366 | Ct Stamps Inc | Pharmacy | 206 Marion Avenue, Mccomb, MS 39648 | 2020-07-31 |
| 1114566122 | Valley Drugs, Inc. | Pharmacy | 327b S Main St, Water Valley, MS 38965-3318 | 2019-12-23 |
| 1851939318 | Smith Pharmacy, Inc. | Pharmacy | 306 Northside Drive, Newton, MS 39345 | 2019-12-16 |
| 1285270801 | Proxsys Rx - Rush LLC | Pharmacy | 14916 Hwy 16 W, Unit #1, Dekalb, MS 39328 | 2019-11-19 |
| 1518501592 | Southwest Pharmacy Inc | Pharmacy | 3000 Plaza Dr Ste B, Tylertown, MS 39667-9227 | 2019-11-01 |
| 1669015210 | Hometown Family Pharmacy, Inc. | Pharmacy | 930 Hall St Ste H, Wiggins, MS 39577-2113 | 2019-10-25 |
| 1225671001 | A & A Infusion & Specialty, LLC | Pharmacy | 124 E Jackson St, Belzoni, MS 39038-3642 | 2019-10-23 |
| 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.