FREDS STORES OF TENNESSEE INC (NPI# 1902831076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902831076 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 1744 |
| Practice Address |
7616 Highway 80 Ruston LA 71270-1164 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 3182476490 |
| Practice Fax Number | 3182476135 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2008-01-11 |
| Authorized Official Name | RICKY CHAMBERS (VP) |
| Authorized Official Telephone | 9012382477 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | Y |
| Parent Organization Name | FREDS INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | 4655RC | LA | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
4655RC | LA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1930189 | 01 | |
| LA | 1268780 | 05 |
| Other Name | Type Code |
|---|---|
| FREDS PHARMACY 1744 | 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 |
7616 HIGHWAY 80 |
| City | RUSTON |
| State | LA |
| Zip Code | 71270-1164 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821315 | Olivia Mason | Marriage & Family Therapist | 413 North Homer Street, Ruston, LA 71270 | 2020-11-04 |
| 1972146132 | Razz Addiction and Recovery, LLC | Family Medicine | 570 Heard Rd, Ruston, LA 71270 | 2019-10-21 |
| 1518435999 | Tenia Holloway | Case Manager/Care Coordinator | 612 Henderson St., F12, Ruston, LA 71270 | 2018-11-05 |
| 1245708718 | A Plus Medical of Ruston LLC | Family Medicine | 612 S Farmerville Street, Ruston, LA 71270 | 2018-11-02 |
| 1255808085 | Amanda M Clark | Specialist/Technologist | 2301 Timberline Ct Apt F105, Ruston, LA 71270 | 2018-10-30 |
| 1912473752 | Lincoln Nova Vital Recovery | Counselor | 4396 Hwy, 80, 617 South Trention, Ruston, LA 71270 | 2018-10-19 |
| 1861975237 | Wymeka Andrea Breaux | Case Manager/Care Coordinator | 705 Martin Luther King Dr., Ruston, LA 71270 | 2018-09-12 |
| 1790292001 | Louquyhanta Foster | Case Manager/Care Coordinator | 593 Belton Rd, Ruston, LA 71270 | 2018-01-08 |
| 1609391010 | Chemia Herron | Counselor | 775 S Bonner, Ruston, LA 71270 | 2017-08-07 |
| 1477083517 | Arnesha Beard | Counselor | 775 South Bonner, Ruston, LA 71270 | 2017-06-12 |
| Find all providers in zip 71270 | ||||
| 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 |
|---|---|---|---|---|
| 1144471848 | Mitchell's Compounding Pharmacy | Pharmacy | 109 N Trenton St, #2, Ruston, LA 71270-4321 | 2008-10-01 |
| 1023156395 | Waltz & Brazzel Pharmacy Inc | Pharmacy | 200 North Trenton Street, Ruston, LA 71270 | 2007-02-01 |
| 1336228931 | Prescription Shoppe, LLC | Pharmacy | 104 W Line Ave, Ruston, LA 71270-5044 | 2006-11-03 |
| 1033738240 | Winn Community Health Center, Inc. | Pharmacy | 1140 S Vienna St, Ruston, LA 71270-5834 | 2020-04-09 |
| 1992064505 | Miller Pharmacy Services LLC | Pharmacy | 104 W Line Ave, Ruston, LA 71270-5044 | 2012-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568054 | Chris Pharmacy of Gonzalez LLC | Pharmacy | 14505 Highway 44 Ste 112, Gonzales, LA 70737-7195 | 2020-11-02 |
| 1639779788 | Harvey Lee Smith Jr. | Pharmacy | 1707 Gardere Ln Ste F, Baton Rouge, LA 70820-8144 | 2020-10-28 |
| 1194331579 | Minden Family Pharmacy LLC | Pharmacy | 120 Homer Rd, Minden, LA 71055 | 2020-09-21 |
| 1093321812 | Community Pharmacy of Sterlington | Pharmacy | 200 Scott Dr, Sterlington, LA 71280 | 2020-09-17 |
| 1386256121 | Lagniappe Pharmacy 7, LLC | Pharmacy | 1900 Saint Charles Ave, New Orleans, LA 70130-5317 | 2020-08-22 |
| 1740890144 | Downtown Drugs Inc | Pharmacy | 338 N Vermont St, Covington, LA 70433-2812 | 2020-07-31 |
| 1053929703 | Viallon Drug Co of Donaldsonville | Pharmacy | 309 Marchand Dr, Donaldsonville, LA 70346-3242 | 2020-07-20 |
| 1619595584 | Brown's Pharmacy, LLC | Pharmacy | 1718 North Foster Drive, Suite B, Baton Rouge, LA 70806 | 2020-07-08 |
| 1417573593 | Doc Your Dose Pharmacy, LLC | Pharmacy | 17275 Hwy 77, Gross Tete, LA 70740 | 2020-06-24 |
| 1942829247 | Good Vibe Ventures LLC | Pharmacy | 5004 W Esplanade Ave Ste A, Metairie, LA 70006-2551 | 2020-04-16 |
| Find all providers with the same taxonomy | ||||
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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.