FREDS STORES OF TENNESSEE INC


Address: 611 Us Hwy 65 South, Suite A, Dumas, AR 71639
Phone: 8703822955

FREDS STORES OF TENNESSEE INC (NPI# 1487796520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1487796520
Entity Type Organization
Organization Name FREDS STORES OF TENNESSEE INC
Other Organization Name FRED'S PHARMACY 1609
Practice Address 611 Us Hwy 65 South
Suite A
Dumas
AR 71639
Mailing Address 6625 Lenox Park Blvd.
Suite 200
Memphis
TN 38115
Practice Telephone 8703822955
Practice Fax Number 8703826709
Mailing Telephone 9012382520
Mailing Fax Number 9013659820
Enumeration Date 2007-02-13
Last Update Date 2019-08-30
Authorized Official Name JOSEPH ANTO (CEO)
Authorized Official Telephone 9013623733
Is Organization Subpart Y
Parent Organization Name FREDS INC
Parent Organization TIN

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 332B00000X Durable Medical Equipment & Medical Supplies 11591 AR Suppliers
Y 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
11591 AR Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
AR 158803407 05
AR DME 179673716 01
NCPDP 0422307 01
LA 1228516 05

Other Provider/Organization Names

Other Name Type Code
FRED'S PHARMACY 1609 Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 611 US HWY 65 SOUTH
SUITE A
City DUMAS
State AR
Zip Code 71639

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1619444338 Susan K Cingolani Licensed Practical Nurse 741 Hwy 65 South, Dumas, AR 71639 2018-10-31
1497993166 Cecily Shae Forrest Case Manager/Care Coordinator 708 Hwy 65 South, Dumas, AR 71639 2009-02-03
1922277714 Amber Gail Bratton Case Manager/Care Coordinator 139 S Main Street, Dumas, AR 71639 2008-02-26
1891919189 Jodie Partridge Center Day Training, Developmentally Disabled Services 1180 Highway 165, Dumas, AR 71639 2007-04-11
1629092929 Delta Memorial Hospital Home Health Hwy 65 North, Dumas, AR 71639 2006-07-27
1295767689 Delta Memorial Hospital General Acute Care Hospital 811 Hwy 65 South, Dumas, AR 71639 2006-07-07
1174569206 City of Dumas Ambulance 149 E Waterman St, Dumas, AR 71639 2006-06-20
1346285533 Lisa M Holaday Specialist 811 Hwy 5 S, Dumas, AR 71639 2006-06-19
1518909605 Shamim A Malik Psychiatry & Neurology Delta Memorial Hospital, 811 Highway 65 South, Dumas, AR 71639 2006-06-12
1639400203 Melissa Faler Case Manager/Care Coordinator 708 Hwy 65 South, Dumas, AR 71639 2010-01-21
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Taxonomy Information

Taxonomy Code 3336C0003X
Grouping Suppliers
Classification Pharmacy
Specialization Community/Retail Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1861673915 Canada, Inc. Pharmacy 101 W. Waterman St, Dumas, AR 71639-0185 2007-11-16
1821101932 Saucedo Pharmacy Inc Pharmacy 1021 E 1st St, Dumas, TX 79029 2006-08-16
1093271728 Dumas Family Pharmacy LLC Pharmacy 301 Highway 65 S, Dumas, AR 71639-2335 2019-02-19
1265962153 Lee's Super Drug Pharmacy 105 W Choctaw St, Dumas, AR 71639-2005 2017-06-14

Providers in the same taxonomy and state

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
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Competitor

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City DUMAS
Zip Code 71639

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Dataset Information

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.

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