FREDS STORES OF TENNESSEE INC (NPI# 1306964812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306964812 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 3176 |
| Practice Address |
9574 Hwy 18 Vernon AL 35592 |
| Mailing Address |
6625 Lenox Park Blvd. Suite 200 Memphis TN 38115 |
| Practice Telephone | 2056951195 |
| Practice Fax Number | 2056951196 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2019-08-02 |
| Authorized Official Name | JOSEPH ANTO (CEO) |
| Authorized Official Telephone | 3478816323 |
| 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 | 112923 | AL | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
112923 | AL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP | 0134320 | 01 | |
| AL | 100003782 | 05 | |
| MS | 05801867 | 05 |
| Other Name | Type Code |
|---|---|
| FREDS PHARMACY 3176 | 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 |
9574 HWY 18 |
| City | VERNON |
| State | AL |
| Zip Code | 35592 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649692922 | Amber Diane Pennington | Nurse Practitioner | 110 Medical Clinic Drive, Vernon, AL 35592 | 2014-01-06 |
| 1063848927 | Encore Rehabilitation, Inc. | Clinic/Center | 44992 Highway 17, Vernon, AL 35592 | 2013-09-23 |
| 1316276751 | Nancy R Kennedy | Counselor | 141 2nd Avenue, Nw, Vernon, AL 35592 | 2009-12-14 |
| 1164624086 | Lamar County | Local Education Agency (LEA) | 150 Butler Circle, Vernon, AL 35592 | 2007-06-04 |
| 1609917707 | Lamar Home Care, Inc. | Home Health | 131 1st Ave. Nw, Suite B, Vernon, AL 35592 | 2007-02-09 |
| 1811066863 | Twin States Home Healthcare, Inc. | Durable Medical Equipment & Medical Supplies | 131 1st Avn. Nw, Vernon, AL 35592 | 2006-11-06 |
| 1669551677 | Larry Joe Whisenant | Dentist | 121 10th St Nw, Vernon, AL 35592 | 2006-11-02 |
| 1902814262 | Terry L Duke | Pharmacist | 170 5th Street Southwest, Vernon, AL 35592 | 2006-08-03 |
| 1992741284 | Robert William Davis | Family Medicine | 45020 Highway 17, Vernon, AL 35592 | 2006-06-22 |
| 1982691929 | John Powell Berry | Chiropractor | 47776 Highway 17, Vernon, AL 35592 | 2005-10-04 |
| Find all providers in zip 35592 | ||||
| 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 |
|---|---|---|---|---|
| 1083758023 | Duco, Inc | Pharmacy | 170 5th St Sw, Vernon, AL 35592-5215 | 2007-02-15 |
| 1013077056 | Great Atlantic & Pacific Tea Company Inc | Pharmacy | 530 Rte 515, Vernon, NJ 07462 | 2006-12-11 |
| 1902423882 | Bolbol LLC | Pharmacy | 79 East St, Vernon, CT 06066-3845 | 2020-06-26 |
| 1861744328 | Hospital Discount Apothecary, Inc | Pharmacy | 170 5th St Sw, Vernon, AL 35592-5215 | 2012-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952909053 | Payne & Pitts, LLC | Pharmacy | 602 Alabama Avenue, Bridgeport, AL 35740-7513 | 2020-10-12 |
| 1366066144 | Jones Drugs LLC | Pharmacy | 3482 Crosswinds Dr, Phenix City, AL 36869 | 2020-06-08 |
| 1104448067 | Hh Health System - Retail Pharmacy LLC | Pharmacy | 201 Governors Dr Sw Ste 305, Huntsville, AL 35801-5170 | 2020-05-14 |
| 1609401678 | Pharmacy Investment Coordinators Inc | Pharmacy | 1301 Andrews Ave, Ozark, AL 36360-3717 | 2020-03-10 |
| 1861025520 | Monroe County Health Care Authority | Pharmacy | 2016 S Alabama Ave Ste D, Monroeville, AL 36460-3044 | 2020-02-20 |
| 1982235230 | Shiftrx Uab Mw, LLC | Pharmacy | 985 9th Ave Sw Ste 100, Bessemer, AL 35022-7810 | 2020-01-27 |
| 1316577943 | Gulf Health Management Services Inc | Pharmacy | 95 Shell St Ste 110, Saraland, AL 36571-2202 | 2020-01-23 |
| 1952931115 | Howard Pharmacy LLC | Pharmacy | 770a Pierce Rd, Mobile, AL 36608-9441 | 2020-01-16 |
| 1972144798 | Hh Health System - Marshall LLC | Pharmacy | 11491 Us Highway 431 Ste 1, Albertville, AL 35950-0136 | 2019-10-02 |
| 1275184517 | Avita Drugs Alabama, LLC | Pharmacy | 3220 5th Ave S, Birmingham, AL 35222-2309 | 2019-09-27 |
| 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.