FREDS SUPER PHARMACY INC (NPI# 1902882426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902882426 |
| Entity Type | Organization |
| Organization Name | FREDS SUPER PHARMACY INC |
| Other Organization Name | FREDS PHARMACY |
| Practice Address |
131 N Grand St Schoolcraft MI 49087 |
| Mailing Address |
Po Box 396 131 N Grand St Schoolcraft MI 49087-0396 |
| Practice Telephone | 2696794061 |
| Practice Fax Number | 2696794621 |
| Mailing Telephone | 2696794061 |
| Mailing Fax Number | 2696794621 |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. FREDERICK WILLIAM NELSON (PRESIDENT OWNER) |
| Authorized Official Telephone | 2696490660 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 5301003028 | MI | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 2529293 | 05 |
| Other Name | Type Code |
|---|---|
| Freds Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982680468 | Freds Super Pharmacy Inc | Pharmacy | 121 W Prairie St, Vicksburg, MI 49097 | 2005-12-16 |
| Street Address |
131 N GRAND ST |
| City | SCHOOLCRAFT |
| State | MI |
| Zip Code | 49087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497128946 | Fms Kalamazoo, LLC | Clinic/Center | 12180 N. Us 131 Hwy, Schoolcraft, MI 49087 | 2015-11-05 |
| 1912257130 | Stephanie Marie Peterson | Behavioral Analyst | 11583 S. 8th St., Schoolcraft, MI 49087 | 2012-09-14 |
| 1992008221 | Amy Taylor Johnson | Occupational Therapist | 4317 West U Avenue, Schoolcraft, MI 49087 | 2010-12-08 |
| 1467646323 | Norma Jean Julien | Contractor | 115 S Grand, Schoolcraft, MI 49087 | 2007-09-04 |
| 1831310093 | Scott Anthony Mais | Chiropractor | 115 South Grand Street, Schoolcraft, MI 49087 | 2007-05-02 |
| 1891989950 | Mais Chiropractic Clinic, PC | Chiropractor | 115 S. Grand Ave., Schoolcraft, MI 49087-0337 | 2007-08-31 |
| 1124057500 | Eric M Graham | Pharmacist | 311 N Grand St, Schoolcraft, MI 49087-5110 | 2006-06-30 |
| 1255859419 | Joanna Olsen | Nurse Practitioner | 311 N Grand St, Schoolcraft, MI 49087-5110 | 2017-09-07 |
| 1639623747 | Danielle Buchheit | Counselor | 311 N Grand St, Schoolcraft, MI 49087-5110 | 2016-08-05 |
| 1457543167 | Red Crown II Inc | Pharmacy | 311 N Grand St, Schoolcraft, MI 49087-5110 | 2007-08-16 |
| Find all providers in zip 49087 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821005257 | Linda Margaret Norton | Pharmacist | 8137 W X Ave, Schoolcraft, MI 49087-9627 | 2006-08-01 |
| 1124057500 | Eric M Graham | Pharmacist | 311 N Grand St, Schoolcraft, MI 49087-5110 | 2006-06-30 |
| 1821379496 | Kimberly Ann Maxam | Pharmacist | 139 N Grand St, Schoolcraft, MI 49087-5111 | 2011-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477710 | Alix Sabbagh | Pharmacist | 154 River Ln, Dearborn, MI 48124-1047 | 2020-11-04 |
| 1659972867 | Bruce Alan Gilmore | Pharmacist | 5940 Augusta Ln, Grand Blanc, MI 48439-9473 | 2020-11-04 |
| 1437750551 | Anamiben R Patel | Pharmacist | 45555 Michigan Ave, Canton, MI 48188-2388 | 2020-11-04 |
| 1871194217 | Rajesh Koduru | Pharmacist | 27496 Pamplona Ln, Novi, MI 48374-4208 | 2020-11-03 |
| 1346841962 | Joy Emery | Pharmacist | 1770 N Alger Road, Alma, MI 48001 | 2020-11-02 |
| 1659972107 | Jane Gruenke | Pharmacist | N10305 Country Club Rd, Ironwood, MI 49938-9627 | 2020-11-02 |
| 1407456254 | Bradley Dwane Murphy | Pharmacist | 6170 S Saginaw, Grand Blanc, MI 48439 | 2020-10-30 |
| 1811597602 | Rachel L Martin | Pharmacist | 600 N Center Ave, Gaylord, MI 49735-1506 | 2020-10-29 |
| 1760081467 | Sam Nasser | Pharmacist | 6610 Reuter St, Dearborn, MI 48126-1898 | 2020-10-22 |
| 1427656990 | Tejal Shah | Pharmacist | 1153 Pembroke Dr, Rochester Hills, MI 48307-5756 | 2020-10-15 |
| Find all providers with the same taxonomy | ||||
| City | SCHOOLCRAFT |
| Zip Code | 49087 |
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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.