FREDS STORES OF TENNESSEE INC (NPI# 1760409239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760409239 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 2366 |
| Practice Address |
1509 Hwy 84 West Monticello MS 39654 |
| Mailing Address |
6625 Lenox Park Blvd. Suite 200 Memphis TN 38115 |
| Practice Telephone | 6015872531 |
| Practice Fax Number | 6015872560 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2006-07-17 |
| 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 |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | 0375301FM | MS | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
0375301FM | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 0330302 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2518934 | 01 |
| Other Name | Type Code |
|---|---|
| FREDS PHARMACY 2366 | 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 |
1509 HWY 84 WEST |
| City | MONTICELLO |
| State | MS |
| Zip Code | 39654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326565417 | David Warren Ready | Pharmacist | 1509 Hwy 84 West, Monticello, MS 39654 | 2017-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013558824 | Downhome Pharmacy, Inc. | Pharmacy | 606 W. Broad St, Monticello, MS 39654 | 2019-10-02 |
| 1700344066 | Southwest Mississippi Regional Medical Center | Surgery | 1065 E Broad St., Monticello, MS 39654 | 2019-03-06 |
| 1457862229 | Susan Nevels | Pharmacist | 1509 Highway 84 West, Monticello, MS 39654 | 2017-10-19 |
| 1861664575 | James Mikel Griffith II | Physical Therapy Assistant | 314 Main St, Ste C, Monticello, MS 39654 | 2008-04-02 |
| 1811169840 | Southwest Mississippi Planning and Development District | Clinic/Center | 1477 Fe Sellers Highway, Monticello, MS 39654 | 2008-03-31 |
| 1447429089 | Foot and Wound Institute of The South | Clinic/Center | 157 Fe Sellers Highway, Monticello, MS 39654 | 2008-02-28 |
| 1346431566 | Amy Eaton Broome | Physical Therapy Assistant | 314 Main St Ste C, Monticello, MS 39654 | 2007-08-05 |
| 1881804532 | Chris Gilbert Boyd | Dentist | 716 Brookhaven Street, Monticello, MS 39654 | 2007-05-23 |
| 1851463707 | Brantley B. Pace | Family Medicine | 713 Watts St., Monticello, MS 39654 | 2006-11-15 |
| 1295818045 | Brenco | Podiatrist | 157 F E Sellers Hwy, Monticello, MS 39654 | 2006-10-23 |
| Find all providers in zip 39654 | ||||
| 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 |
|---|---|---|---|---|
| 1942847686 | Burgess Drug Store Inc. | Pharmacy | 1 S. Creek Dr., Ste. #122, Monticello, KY 42633 | 2019-12-02 |
| 1992104442 | Silvers Hometown Pharmacy,llc | Pharmacy | 1251 W Columbia Ave, Monticello, KY 42633-3177 | 2014-08-21 |
| 1710179072 | Monticello Pharmacy, Inc. | Pharmacy | 41 Jefferson St., Monticello, NY 12701 | 2007-08-10 |
| 1952493579 | Lawrence County Drugs, Inc. | Pharmacy | 422 E Broad St, Monticello, MS 39654 | 2006-09-29 |
| 1568074714 | Kirby Medical Center | Pharmacy | 1402 N Market St, Monticello, IL 61856-8002 | 2020-08-19 |
| 1437711140 | Kirby Medical Center | Pharmacy | 1000 Medical Center Dr, Monticello, IL 61856-2116 | 2019-07-02 |
| 1649793589 | Walgreen Co | Pharmacy | 381 Broadway, Monticello, NY 12701-1385 | 2017-07-24 |
| 1134526585 | Hartig Drug Co Corp | Pharmacy | 419 E 1st St, Monticello, IA 52310-1506 | 2014-12-01 |
| 1215144308 | San Juan Pharmacy Monticello | Pharmacy | 140 S Main St, Monticello, UT 84535 | 2007-05-17 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | MONTICELLO |
| Zip Code | 39654 |
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.