FREDS STORES OF TENNESSEE INC (NPI# 1770515702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770515702 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 3311 |
| Practice Address |
507 W Pine St Warren AR 71671-2501 |
| Mailing Address |
6625 Lenox Park Blvd. Suite 200 Memphis TN 38115 |
| Practice Telephone | 8702265522 |
| Practice Fax Number | 8702265554 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2006-07-07 |
| 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 | 420142 | AR | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
420142 | AR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 0420341 | 01 | |
| AR | 134879407 | 05 | |
| AR | DME | 156723716 | 01 |
| Other Name | Type Code |
|---|---|
| FREDS PHARMACY 3311 | 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 |
507 W PINE ST |
| City | WARREN |
| State | AR |
| Zip Code | 71671-2501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053620823 | Julie R King | Pharmacist | 507 W Pine St, Warren, AR 71671-2501 | 2010-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992116396 | Bradley Newton Biggers | Family Medicine | 304 E Central St., Warren, AR 71671 | 2014-05-19 |
| 1558602003 | Kelley M Hollingsworth | Licensed Practical Nurse | 1404 East Church Street, Warren, AR 71671 | 2013-03-08 |
| 1245516228 | Lauren Lynch | Pharmacist | 507 W Pine, Warren, AR 71671 | 2011-10-22 |
| 1114237062 | Gary Maskell | Chiropractor | 210 East Shields Street, Warren, AR 71671 | 2010-10-13 |
| 1841442811 | Wagnon Place Health Facilities | Skilled Nursing Facility | 1440 East Church Street, Warren, AR 71671 | 2008-10-21 |
| 1104953629 | Kathryn Kelly Cash | Speech-Language Pathologist | 206 Bragg St., Warren, AR 71671 | 2007-02-28 |
| 1477628352 | University of Arkansas for Medical Sciences | Pediatrics | 222 E Central St, Warren, AR 71671 | 2006-11-23 |
| 1649383514 | Karen Walker | Social Worker | 1404 E Church, Warren, AR 71671 | 2006-08-16 |
| 1699705178 | Rosemary Bell | Licensed Practical Nurse | 1404 E Church St, Warren, AR 71671 | 2006-07-03 |
| 1992348551 | Charles C Gibson | Case Manager/Care Coordinator | 1404 E Church St, Warren, AR 71671 | 2019-10-25 |
| Find all providers in zip 71671 | ||||
| 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 |
|---|---|---|---|---|
| 1679118236 | Good N Plenty Rx LLC | Pharmacy | 22260 Van Dyke Avenue, Warren, MI 48089 | 2019-11-07 |
| 1891337804 | Warren Family Pharmacy LLC | Pharmacy | 29156 Hoover Rd, Warren, MI 48093-3476 | 2019-10-10 |
| 1629532593 | Prestige Specialty Pharmacy 3 | Pharmacy | 31700 Van Dyke Ave Ste C, Warren, MI 48093-7949 | 2019-01-24 |
| 1871019422 | Highland Rx | Pharmacy | 26000 Hoover Rd Ste 107, Warren, MI 48089-1167 | 2017-08-16 |
| 1417472697 | Jp Pharmacy Inc. | Pharmacy | 27301 Schoenherr Rd Ste 106, Warren, MI 48088-6649 | 2017-08-08 |
| 1013431014 | Shah Alam Bhuiyan | Pharmacy | 24831 Ryan Rd, Warren, MI 48091-3390 | 2017-08-01 |
| 1427578483 | Elwaseem & Associates LLC | Pharmacy | 4208 E 9 Mile Rd, Warren, MI 48091-2578 | 2017-06-21 |
| 1952832990 | Genoa Healthcare, LLC | Pharmacy | 103 W Market St Ste P, Warren, OH 44481-1017 | 2017-03-22 |
| 1033667472 | Greater Care Pharmacy LLC | Pharmacy | 24800 Hoover Rd Ste B, Warren, MI 48089-1965 | 2016-09-14 |
| 1871913640 | Hoover Drugs LLC | Pharmacy | 28675 Hoover Rd, Warren, MI 48093-4152 | 2014-04-21 |
| Find all providers in WARREN | ||||
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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.