FREDS STORES OF TENNESSEE INC. (NPI# 1790053502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790053502 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC. |
| Other Organization Name | FRED'S PHARMACY 2529 |
| Practice Address |
652 Hwy 365 Mayflower AR 72106 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2012-09-11 |
| Authorized Official Name | RICK CHAMBERS (VICE PRESIDENT) |
| Authorized Official Telephone | 9012382477 |
| Is Organization Subpart | Y |
| Parent Organization Name | FRED'S 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 |
|---|---|---|---|
| AR | 190691407 | 05 |
| Other Name | Type Code |
|---|---|
| Fred's Pharmacy 2529 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770906737 | Freds Stores of Tennessee Inc. | Pharmacy | 808 Nc Highway 69, Hayesville, NC 28904-9696 | 2014-01-28 |
| 1275963753 | Freds Stores of Tennessee Inc. | Pharmacy | 418 A West Central Avenue, Jamestown, TN 38556 | 2013-11-19 |
| 1548602758 | Freds Stores of Tennessee Inc. | Pharmacy | 11858 S Main St, Trenton, GA 30752 | 2013-07-29 |
| 1043659394 | Freds Stores of Tennessee Inc. | Pharmacy | 2110 Goodman Rd E, Southaven, MS 38672-9006 | 2013-06-20 |
| 1285970988 | Freds Stores of Tennessee Inc. | Pharmacy | 5751 Shed Rd, Bossier City, LA 71111 | 2012-12-27 |
| 1447524145 | Freds Stores of Tennessee Inc. | Pharmacy | 400 W. Mckinley Ave., Haughton, LA 71037-9449 | 2012-02-28 |
| 1255609871 | Freds Stores of Tennessee Inc. | Pharmacy | 21361 Whyte Hardee Blvd., Hardeeville, SC 29927 | 2011-12-09 |
| 1013299080 | Freds Stores of Tennessee Inc. | Pharmacy | 306 Lamar St, Kilmichael, MS 39747-9732 | 2011-09-15 |
| 1588061394 | Freds Stores of Tennessee Inc. | Pharmacy | 214 S Main St, Fairmont, NC 28340-1904 | 2014-11-21 |
| 1104235316 | Freds Stores of Tennessee Inc. | Pharmacy | 211 South Main Street, Morgantown, KY 42261 | 2014-08-13 |
| Street Address |
652 HWY 365 |
| City | MAYFLOWER |
| State | AR |
| Zip Code | 72106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790306124 | Jbr Enterprises Inc | Pharmacy | 600 Hwy 365, Mayflower, AR 72106 | 2020-04-27 |
| 1285903955 | Melissa Wallace | Physical Therapist | 582 Hwy 365 Ste 3, Mayflower, AR 72106 | 2011-12-23 |
| 1922136746 | My House, Inc. | Case Management | #760 Highway 365 South, Mayflower, AR 72106 | 2007-03-01 |
| 1407914583 | Mayflower School | Local Education Agency (LEA) | 18 Eagle Cir., Mayflower, AR 72106 | 2006-12-04 |
| 1407890577 | Erin R. Lewis | Physical Therapist | 4 Grove Street, Mayflower, AR 72106 | 2006-06-16 |
| 1790867257 | Mayflower Family Medicine | Clinic/Center | 587 Highway 365, Mayflower, AR 72106 | 2006-10-20 |
| 1033219753 | Shelly M Clifton | Nurse Practitioner | 587 Highway 365, Mayflower, AR 72106 | 2006-09-23 |
| 1902235302 | Jami Lynn Faulkner | Dietitian, Registered | 6 Ledrick Cir, Mayflower, AR 72106-8404 | 2013-11-06 |
| 1700194990 | John B Witherspoon Optometric Physician Ltd | Optometrist | 29 River Road Dr E, Mayflower, AR 72106-8409 | 2010-09-22 |
| 1780912444 | Margaret M Healy | Social Worker | 50 River Bend Rd, Mayflower, AR 72106-8415 | 2009-11-18 |
| Find all providers in zip 72106 | ||||
| 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 |
|---|---|---|---|---|
| 1790306124 | Jbr Enterprises Inc | Pharmacy | 600 Hwy 365, Mayflower, AR 72106 | 2020-04-27 |
| 1164998498 | Thilo Pharmacy Services | Pharmacy | 637 Highway 365, Mayflower, AR 72106-9630 | 2018-10-14 |
| 1407985161 | T&c Watson | Pharmacy | 582 Highway 365, Suite B, Mayflower, AR 72106-9524 | 2007-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356942320 | Freda Cunningham | Pharmacy | 2100 Hwy 77, Marion, AR 72364 | 2020-11-05 |
| 1457978157 | Sc Pharmacy Group Opco LLC | Pharmacy | 1800 Riverfront Dr Ste 100, Little Rock, AR 72202-1882 | 2020-06-29 |
| 1215557905 | Medman23, Inc | Pharmacy | 3201 Springhill Dr Ste 110, North Little Rock, AR 72117-2910 | 2020-04-22 |
| 1336768985 | Harps Food Stores, Inc | Pharmacy | 611 Highway 62 65 N, Harrison, AR 72601-2208 | 2020-04-14 |
| 1598393605 | Highlands Oncology Group Pa | Pharmacy | 3901 Parkway Circle, Springdale, AR 72762 | 2020-04-01 |
| 1326674870 | Caraway Drug L.l.c | Pharmacy | 106 W. State Street, Caraway, AR 72419 | 2020-03-17 |
| 1104461532 | Pruett's Food, Inc. | Pharmacy | 101 W. Main, Lockesburg, AR 71846 | 2019-11-08 |
| 1760025274 | Holiday Island Pharmacy, LLC | Pharmacy | 2 Forest Park Dr Ste A, Holiday Island, AR 72631-9229 | 2019-10-28 |
| 1730722463 | Beebe Family Pharmacy, LLC | Pharmacy | 1701 W Dewitt Henry Dr, Beebe, AR 72012-2024 | 2019-10-25 |
| 1619519436 | Donna Ring Corporation | Pharmacy | 138 S 2nd, Piggott, AR 72454 | 2019-10-14 |
| Find all providers with the same taxonomy | ||||
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.