FREDS STORES OF TENNESSEE INC


Address: 1000 Broadway Dr Ste 50, Hattiesburg, MS 39401-7572
Phone: 6015836411

FREDS STORES OF TENNESSEE INC (NPI# 1578595518) 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) 1578595518
Entity Type Organization
Organization Name FREDS STORES OF TENNESSEE INC
Other Organization Name FREDS PHARMACY 1906
Practice Address 1000 Broadway Dr Ste 50
Hattiesburg
MS 39401-7572
Mailing Address 4300 New Getwell Rd
Memphis
TN 38118-6801
Practice Telephone 6015836411
Practice Fax Number 6015847796
Mailing Telephone 9012382520
Mailing Fax Number 9013659820
Enumeration Date 2006-07-07
Last Update Date 2012-04-03
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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 333600000X Pharmacy 0441601FH MS Suppliers
Y 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
0441601FH MS Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
MS 0330461 05
OTHER ID NUMBER-COMMERCIAL NUMBER 2519708 01

Other Provider/Organization Names

Other Name Type Code
FREDS PHARMACY 1906 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 1000 BROADWAY DR STE 50
City HATTIESBURG
State MS
Zip Code 39401-7572

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1598315863 Lisa Thornton Technician 18 Timberline Dr., Hattiesburg, MS 39401 2019-09-18
1548813637 Caroline Estes Barnes Counselor Barnes, 8 App Slade Road, Hattiesburg, MS 39401 2019-07-18
1396252441 Selection Healthcare Services, LLC In Home Supportive Care 606 Adeline St Ste 1c, Hattiesburg, MS 39401 2018-01-10
1225545585 Whitney Wilkinson Nurse Practitioner 301 South 28th Avenue, Hattiesburg, MS 39401 2018-01-08
1740795806 Forrest General Hospital Pharmacy 1414 South 28th Avenue, Hattiesburg, MS 39401 2017-12-11
1275058455 Casey Payne Pharmacist 6130 Us 49, Hattiesburg, MS 39401 2017-08-08
1225562705 Sarah Marie Hudson Family Medicine 6051 Us Highway 49 S, Hattiesburg, MS 39401 2017-04-12
1043671704 The Covington's Cove Assisted Living Center LLC Assisted Living Facility 192 Mary Magdalene Church Rd, Hattiesburg, MS 39401 2016-03-09
1780083626 Dominique Reed Watson Pharmacist 602 Adeline St, Hattiesburg, MS 39401 2014-08-15
1558778936 Willie Davis Jr. Day Training, Developmentally Disabled Services 701 Duke Ave., Hattiesbiurg, MS 39401 2014-07-17
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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
1295169753 30a Innovations,llc Pharmacy 3902 Hardy St, Hattiesburg, MS 39402-1541 2013-09-02
1174803993 Auxilium Specialty Apothecary Pharmacy Inc Pharmacy 16 Keystone Dr Ste B, Hattiesburg, MS 39402-6121 2011-08-24
1598913972 Advantage Medical Infusion LLC Pharmacy 5296 Old Highway 11, Suite 4, Hattiesburg, MS 39402-8380 2008-08-28
1790820645 Newpointe Pharmacy Pharmacy 6555 U S Highway 98, Suite 6, Hattiesburg, MS 39402-8699 2007-02-20
1508965815 Mississippi Cvs Pharmacy, L.L.C. Pharmacy 3910 Hardy St, Hattiesburg, MS 39402-1500 2006-09-22
1760409585 Village Pharmacy, L.L.C. Pharmacy 560 Weathersby Rd, Suite 170, Hattiesburg, MS 39402-1164 2006-07-16
1548674658 Southern Bone & Joint Specialists Pharmacy 3688 Veterans Memorial Dr Ste 200, Hattiesburg, MS 39401 2014-06-17
1144383613 Pomank Ventures LLC Pharmacy 500 Katie Ave, Hattiesburg, MS 39401-4380 2006-12-18
1992800502 Freds Stores of Tennessee Inc Pharmacy 5266 Old Highway 11, Suite 160, Hattiesburg, MS 39402-7817 2006-09-14

Providers in the same taxonomy and state

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
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Competitor

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City HATTIESBURG
Zip Code 39401

Improve Information

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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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