FREDS STORES OF TENNESSEE INC (NPI# 1649516345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649516345 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 2091 |
| Practice Address |
5590 Barksdale Blvd Bossier City LA 71112 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 9012382520 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2012-12-27 |
| Last Update Date | 2013-09-26 |
| Authorized Official Name | RICK CHAMBERS (VICE PRESIDENT) |
| Authorized Official Telephone | 9012382477 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2201883 | 05 |
| Other Name | Type Code |
|---|---|
| Freds Pharmacy 2091 | 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 |
5590 BARKSDALE BLVD |
| City | BOSSIER CITY |
| State | LA |
| Zip Code | 71112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437587342 | Kirsten Palmer | Pharmacist | 5590 Barksdale Blvd, Bossier City, LA 71112-8703 | 2013-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154810349 | Brittany Ariel Boone | Case Manager/Care Coordinator | 2323 Old Minden Rd Ste 500, Bossier City, LA 71112 | 2018-05-03 |
| 1396254520 | Abartllc | Non-emergency Medical Transport (VAN) | 400 John Wesley Blvd Apt 195, Bossier City, LA 71112 | 2017-09-19 |
| 1124547708 | Kendra Webster | Counselor | 3018 Old Minden Rd. Ste 1200, Bossier City, LA 71112 | 2017-09-14 |
| 1851818009 | Latonya Renee' Williams | Case Manager/Care Coordinator | 5383 Bluebell Dr, Bossier City, LA 71112 | 2017-08-28 |
| 1578084299 | Christian Sledge | Counselor | 1011 Princeton Ave, Bossier City, LA 71112 | 2017-07-03 |
| 1861925240 | Kyanna Williams Cosby | Counselor | 4009 Parkway Dr, Bossier City, LA 71112 | 2017-04-04 |
| 1962858191 | Jemeel Latrice Webb | Case Manager/Care Coordinator | 1787 Southview Drive, Bossier City, LA 71112 | 2016-05-06 |
| 1174986244 | Jaquitua Russell | Case Manager/Care Coordinator | 5005 Longstreet Pl Unit 1, Bossier City, LA 71112 | 2016-04-05 |
| 1528423175 | Deanna Lorraine Edwards | Contractor | 4007 Parkway Dr, Bossier City, LA 71112 | 2015-12-28 |
| 1700258605 | Derrick Thomas | Counselor | 2601 Hoyer St, Bossier City, LA 71112 | 2015-10-30 |
| Find all providers in zip 71112 | ||||
| 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 |
|---|---|---|---|---|
| 1144623950 | Wal-mart Stores East Lp | Pharmacy | 5700 Shed Rd, Bossier City, LA 71111-5661 | 2014-10-07 |
| 1144646803 | Healthscripts of America-north Louisiana, LLC | Pharmacy | 5050 Industrial Drive Ext, Suite 200, Bossier City, LA 71112-2631 | 2014-03-05 |
| 1386067007 | Medrx Specialty Pharmacy, LLC. | Pharmacy | 4726 E Texas St, Suite 230, Bossier City, LA 71111-2545 | 2014-01-31 |
| 1285970988 | Freds Stores of Tennessee Inc. | Pharmacy | 5751 Shed Rd, Bossier City, LA 71111 | 2012-12-27 |
| 1891899738 | Louisiana Cvs Pharmacy, L.L.C. | Pharmacy | 4890 Barksdale Blvd, Bossier City, LA 71112-4566 | 2006-09-12 |
| 1851400253 | K and B Louisiana Corporation | Pharmacy | 2925 E Texas St, Bossier City, LA 71111-3201 | 2006-08-30 |
| 1710994892 | Walgreen Co | Pharmacy | 3400 Airline Dr, Bossier City, LA 71111-2122 | 2006-08-02 |
| 1760497937 | Walgreen Co | Pharmacy | 2107 Airline Dr, Bossier City, LA 71111-3105 | 2006-07-29 |
| 1518482447 | Airline Drug LLC | Pharmacy | 4160 Airline Dr, Bossier City, LA 71111-2050 | 2017-08-11 |
| 1962830091 | Cvs | Pharmacy | 3001 E Texas St, Bossier City, LA 71111-3207 | 2013-10-29 |
| Find all providers in BOSSIER CITY | ||||
| City | BOSSIER CITY |
| Zip Code | 71112 |
Please comment or provide details below to improve the information on FREDS STORES OF TENNESSEE INC.
| 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.