FREDS STORES OF TENNESSEE INC (NPI# 1750313698) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750313698 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 1894 |
| Practice Address |
905 N Pontotoc St Houston MS 38851-1516 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 6624486011 |
| Practice Fax Number | 6624486014 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2008-09-25 |
| 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 |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 6309012 | MS | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
6309012 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 07375077 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2521892 | 01 |
| Other Name | Type Code |
|---|---|
| FREDS PHARMACY 1894 | 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 |
905 N PONTOTOC ST |
| City | HOUSTON |
| State | MS |
| Zip Code | 38851-1516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043737810 | Deborah Smith | Pharmacist | 905 N Pontotoc St, Houston, MS 38851-1516 | 2017-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144742073 | Natalie Mitchell | Social Worker | 102 Okolona Cutoff Rd, Houston, MS 38851 | 2017-07-12 |
| 1073041042 | Jan Sherlene Paden | Nurse Practitioner | 8 East Madison St, Houston, MS 38851 | 2017-06-02 |
| 1851772818 | Shell Denece Williams-moore | Religious Nonmedical Practitioner | 901 North Jackson Street, Houston, MS 38851 | 2015-06-16 |
| 1740385491 | Southern Health Corp of Houston Inc | Skilled Nursing Facility | 1000 East Madison, Houston, MS 38851 | 2006-09-14 |
| 1730281809 | Teena Freeman Horn | Dentist | 327 N Jackson St, Houston, MS 38851 | 2006-09-01 |
| 1891776530 | Kunthavai S. Patel | Specialist | 208 Country Club Road, Houston, MS 38851 | 2005-11-09 |
| 1255467726 | North Mississippi Foot Specialists PC | Durable Medical Equipment & Medical Supplies | Hwy 8 East, Houston, MS 38851 | 2007-02-26 |
| 1689753485 | Southern Health Corp of Houston Inc | Psychiatric Unit | Highway 8 East, Houston, MS 38851 | 2006-11-03 |
| 1306925102 | Southern Health Corp of Houston Inc | Medicare Defined Swing Bed Unit | Highway 8 East, Houston, MS 38851 | 2006-11-03 |
| 1134212038 | Chickasaw Dental Group L. L. C. | Dentist | 327 N Jackson St, Houston, MS 38851 | 2006-10-02 |
| Find all providers in zip 38851 | ||||
| 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] |
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| 1629679410 | Duehan Tran Ngo | Pharmacy | 403 W Sam Houston Pkwy N, Houston, TX 77024-4736 | 2020-11-06 |
| 1356942767 | Rxassist Pharmacy, Inc. | Pharmacy | 17020 Beaver Springs Dr Ste 8, Houston, TX 77090-2398 | 2020-11-03 |
| 1861091977 | A Medizona Pharmacy | Pharmacy | 3700 Barker Cypress Rd, Suite 700, Houston, TX 77084 | 2020-10-20 |
| 1194324277 | Rite Scripts Pharmacy Inc | Pharmacy | 13835 Westhollow Park Dr Apt 2805, Houston, TX 77082-1885 | 2020-10-20 |
| 1538766019 | Hpb Pharmacy | Pharmacy | 6410 Fannin St Ste 116, Houston, TX 77030-3006 | 2020-10-07 |
| 1811594823 | Taha Pharmacy | Pharmacy | 1383 Bunker Hill Rd, 101, Houston, TX 77055 | 2020-10-02 |
| 1346857471 | Tulson Pharmacy, LLC | Pharmacy | 3235 Holman St, Houston, TX 77004-3541 | 2020-09-23 |
| 1487260998 | L K & E Management Inc | Pharmacy | 8880 Bellaire Blvd Ste B2, Houston, TX 77036-4621 | 2020-09-20 |
| 1235744459 | Royal Nandina Inc | Pharmacy | 11970 Wilcrest Dr # 105a, Houston, TX 77031-1923 | 2020-09-14 |
| 1386256816 | The Queen LLC | Pharmacy | 2600 S Loop W Ste 435a, Houston, TX 77054-2653 | 2020-08-17 |
| Find all providers in HOUSTON | ||||
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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.