FREDS STORES OF TENNESSEE INC (NPI# 1740212786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740212786 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 1389 |
| Practice Address |
85 Kidspeace Dr Bowdon GA 30108-3449 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 7702580158 |
| Practice Fax Number | 7702580156 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2008-01-11 |
| Authorized Official Name | RICKY CHAMBERS (VP) |
| Authorized Official Telephone | 9012382477 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | Y |
| Parent Organization Name | FREDS INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | PHRE008991 | GA | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE008991 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1153725 | 01 |
| Other Name | Type Code |
|---|---|
| FREDS PHARMACY 1389 | 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 |
85 KIDSPEACE DR |
| City | BOWDON |
| State | GA |
| Zip Code | 30108-3449 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184811465 | Leigh Anne Hatten | Massage Therapist | 723 E College St, Apt 1, Bowdon, GA 30108 | 2007-10-01 |
| 1316093115 | Susan Cackowski | Chiropractor | 111 Lovvorn Ave, Bowdon, GA 30108 | 2007-01-25 |
| 1417029729 | Kidspeace National Centers of Georgia Inc | Psychiatric Residential Treatment Facility | 101 Kidspeace Drive, Bowden, GA 30108 | 2006-11-14 |
| 1922020312 | Michael Craig Widener | Dentist | 328 East College St., Bowdon, GA 30108 | 2006-07-24 |
| 1417474446 | Norie Cescutti Rogers | Counselor | 101 Kidspeace Drive, Bowdon, GA 30108 | 2017-08-30 |
| 1073622593 | Rite Aid of Georgia Inc | Durable Medical Equipment & Medical Supplies | 128 Lovvorn Avenue, Bowdon, GA 30108-1000 | 2006-08-29 |
| 1689032757 | Johnson and Entrekin Pharmacy LLC | Pharmacy | 205 E College St, Bowdon, GA 30108-1108 | 2016-02-04 |
| 1124310933 | Michelle Goldbach | Pharmacist | 128 Lovvorn Ave, Bowdon, GA 30108-1141 | 2011-05-11 |
| 1013431634 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 128 Lovvorn Ave, Bowdon, GA 30108-1141 | 2017-07-26 |
| 1043685779 | Robert Mccants Harris IIi | Pharmacist | 128 Lovvorn Ave, Bowdon, GA 30108-1141 | 2015-12-07 |
| Find all providers in zip 30108 | ||||
| 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 |
|---|---|---|---|---|
| 1689032757 | Johnson and Entrekin Pharmacy LLC | Pharmacy | 205 E College St, Bowdon, GA 30108-1108 | 2016-02-04 |
| 1164455341 | Sims Pharmacy Inc | Pharmacy | 301 W College St, Bowdon, GA 30108-1309 | 2006-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154922441 | Southern Pharmacy Group LLC | Pharmacy | 110 Allison St., Jesup, GA 31545 | 2020-11-04 |
| 1184225526 | Svdp Georgia Community Pharmacy LLC | Pharmacy | 2050 Chamblee Tucker Rd Ste C, Chamblee, GA 30341-3343 | 2020-11-03 |
| 1194325860 | Panola Pharmacy LLC | Pharmacy | 2348 Panola Rd Unit C, Lithonia, GA 30058-5406 | 2020-10-30 |
| 1659971539 | Bob and Jeff's Hometown Pharmacy of Thomasville, LLC | Pharmacy | 309 Smith Ave, Thomasville, GA 31792-5534 | 2020-10-29 |
| 1679171979 | Dfg LLC | Pharmacy | 638 Historic Hwy 441 Suite A, Demorest, GA 30530 | 2020-10-09 |
| 1033716915 | Au Medical Center, Inc. | Pharmacy | 818 Saint Sebastian Way Ste 402, Augusta, GA 30901-2654 | 2020-10-05 |
| 1043817208 | Mlk Pharmacy2.0 | Pharmacy | 2457 Mlk Jr Dr Sw Ste A, Atlanta, GA 30311-1712 | 2020-10-01 |
| 1508470964 | Swain Drug Company LLC | Pharmacy | 855 Bowens Mill Rd Sw Suite E, Douglas, GA 31533 | 2020-09-03 |
| 1205446341 | Sunny Pharmacy | Pharmacy | 5364 Jonesboro Rd, Lake City, GA 30260-3557 | 2020-08-04 |
| 1841818044 | Hospital Authority of Miller County | Pharmacy | 213 Delores Street, Colquitt, GA 39837 | 2020-07-14 |
| 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.