FREDS STORES OF TENNESSEE INC (NPI# 1831413061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831413061 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 1966 |
| Practice Address |
1181 Main St Munfordville KY 42765-9433 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 2705240020 |
| Practice Fax Number | 2705240023 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2011-08-15 |
| 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 | KY | Suppliers | |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
KY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100122870 | 05 |
| Other Name | Type Code |
|---|---|
| Freds Pharmacy 1966 | 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 |
1181 MAIN ST |
| City | MUNFORDVILLE |
| State | KY |
| Zip Code | 42765-9433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518432459 | Justin Dixon | Pharmacist | 1181 Main St, Munfordville, KY 42765-9433 | 2018-10-08 |
| 1770891145 | John Edwin Svoboda | Pharmacist | 1181 Main St, Munfordville, KY 42765-9433 | 2010-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174132997 | All Smiles Therapy, LLC | Speech-Language Pathologist | 114 W Union Street, Munfordville, KY 42765 | 2020-07-28 |
| 1922385129 | Wanda Sexton | Counselor | 103 E. South St., Munfordville, KY 42765 | 2011-11-16 |
| 1215217328 | Brandy Gayle Pierce | Registered Nurse | 117 West South St., Munfordville, KY 42765 | 2011-08-19 |
| 1447588488 | Jackie A. Pandeya | Nurse Practitioner | 950 Main St., Munfordville, KY 42765 | 2009-12-03 |
| 1295955961 | Jill Lynn Humphrey | Speech-Language Pathologist | 3316 Macon Kessinger Rd, Munfordville, KY 42765 | 2007-04-26 |
| 1790801694 | Christina L Johns | Counselor | 118 West Union St., Munfordville, KY 42765 | 2007-03-22 |
| 1083741326 | Louisville Optometric Center, IIi, Psc | Optometrist | 815 Main St., Munfordville, KY 42765 | 2007-02-27 |
| 1245365527 | Anastasia Stacy Wyatt | Counselor | 118 West Union Street, Munfordville, KY 42765 | 2007-02-23 |
| 1306987847 | Laura A Gaines | Social Worker | 118 West Union St, Munfordville, KY 42765 | 2007-02-09 |
| 1427015890 | Hart County Ambulance Service,taxing District | Ambulance | 20 Ambulance Drive, Munfordville, KY 42765 | 2006-04-28 |
| Find all providers in zip 42765 | ||||
| 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 |
|---|---|---|---|---|
| 1710410022 | Jane's Pharmacy, LLC | Pharmacy | 950 Main St, Suite 100, Munfordville, KY 42765-9435 | 2017-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306445259 | Middletown Pharmacist Group | Pharmacy | 11601 Shelbyville Rd Ste B, Louisville, KY 40243-1309 | 2020-10-21 |
| 1144828724 | Pharmacy Care Center | Pharmacy | 10616 South Ky Hwy 15, Scuddy, KY 41760 | 2020-10-15 |
| 1497361208 | Kerry Hettinger | Pharmacy | 1114 Schiller Ave, Louisville, KY 40204-1946 | 2020-09-17 |
| 1114539822 | B&b Pharmacy, Pllc | Pharmacy | 126 Shadowmeade Lane, Unit 2, Mount Washington, KY 40047 | 2020-08-24 |
| 1376161588 | Arh Mary Breckinridge Health Services, Inc. | Pharmacy | 3504 West Cumberland Ave, Middlesboro, KY 40965-2612 | 2020-07-14 |
| 1073139531 | Cornerstone Care Associates | Pharmacy | 1509 1/2 Lexington Rd Ste 2, Richmond, KY 40475-1060 | 2020-06-21 |
| 1912523614 | Oldham Pharmacist Group | Pharmacy | 1000 Cherrywood Pl Ste 100, La Grange, KY 40031-8927 | 2020-06-18 |
| 1578187209 | St. Elizabeth Medical Center, Inc. | Pharmacy | 1 Medical Village Dr., Edgewood, KY 41017 | 2020-05-28 |
| 1922629997 | Classic Specialty Pharmacy Pllc | Pharmacy | 3582 Springhurst Blvd, Louisville, KY 40241-4141 | 2020-05-01 |
| 1346860095 | Dupont Pharmacy, LLC | Pharmacy | 3924 S Dupont Sq Ste D, Louisville, KY 40207-5912 | 2020-04-23 |
| Find all providers with the same taxonomy | ||||
| City | MUNFORDVILLE |
| Zip Code | 42765 |
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.