FREDS STORES OF TENNESSEE INC (NPI# 1275809907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275809907 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 1871 |
| Practice Address |
2549 N Central Ave Humboldt TN 38343-1742 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 7317842621 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2018-10-30 |
| Authorized Official Name | BETTY NGO (VP, REIMBURSEMENT PROGRAMS) |
| Authorized Official Telephone | 6095600089 |
| Is Organization Subpart | Y |
| Parent Organization Name | FREDS INC |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Freds Pharmacy 1871 | 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 |
2549 N CENTRAL AVE |
| City | HUMBOLDT |
| State | TN |
| Zip Code | 38343-1742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447860507 | Fph LLC | Pharmacy | 2200 N Central Ave, Humbolt, TN 38343 | 2020-08-04 |
| 1942774336 | Lisa Danielle Taylor | Occupational Therapy Assistant | 3513 Chere Carol Rd., Humboldt, TN 38343 | 2019-01-18 |
| 1336633916 | Rachel Mccarley | Physical Therapist | 2400mitchell St, Humboldt, TN 38343 | 2018-06-18 |
| 1346521911 | Barbara Jean Potts | Registered Nurse | 149 12th Street, Humboldt, TN 38343 | 2011-09-08 |
| 1871881920 | Joyce Ama Addo | Physician Assistant | 1804 Main Street, Rainbow Pediatric, Humboldt, TN 38343 | 2011-07-11 |
| 1508161126 | Rhatrenton Mr Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 195 Turner's Loop, Humboldt, TN 38343 | 2011-01-12 |
| 1053616672 | Rha Trenton Mr Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 205 Turner's Loop, Humboldt, TN 38343 | 2011-01-12 |
| 1013219252 | Behavioral Outreach Services, LLC | Community/Behavioral Health | 142 Mason Cemetery Rd, Humboldt, TN 38343 | 2010-11-19 |
| 1528373131 | Edmon Jonh Moreno Hilario | Physical Therapist | 2400 Mitchell Street, Humboldt, TN 38343 | 2010-08-09 |
| 1326376948 | Humboldt Area Rescue Squad/ems | Ambulance | 2707 East End Drive, Humboldt, TN 38343 | 2009-11-19 |
| Find all providers in zip 38343 | ||||
| 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 |
|---|---|---|---|---|
| 1891333696 | Emma Stubblefield Dull | Pharmacy | 2401 N Central Ave, Humboldt, TN 38343-1753 | 2019-12-12 |
| 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.