FREDS STORES OF TENNESSEE INC (NPI# 1992038533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992038533 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 3938 |
| Practice Address |
734 N Greenwood Ave Ware Shoals SC 29692-1233 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 8644562117 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2011-08-09 |
| 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 | 10628 | SC | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
10628 | SC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 710628 | 05 | |
| SC | MEDICAID DME | DE3365 | 01 |
| NCPDP | 4229212 | 01 |
| Other Name | Type Code |
|---|---|
| Freds Pharmacy 3938 | 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 |
734 N GREENWOOD AVE |
| City | WARE SHOALS |
| State | SC |
| Zip Code | 29692-1233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053629519 | Stacey Bass | Pharmacist | 734 N Greenwood Ave, Ware Shoals, SC 29692-1233 | 2010-09-18 |
| 1205144490 | Joseph Seth Pulley | Pharmacist | 734 N Greenwood Ave, Ware Shoals, SC 29692-1233 | 2010-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235743295 | Kp and Rd LLC | Pharmacy | 721 N Greenwood Avenue, Ware Shoals, SC 29692 | 2020-09-06 |
| 1639541972 | Ally Child and Family Counseling, LLC | Counselor | 2924 Nation Road, Ware Shoals, SC 29692 | 2015-10-27 |
| 1942528161 | Self Medical Group | Family Medicine | 167 Greenwood Ave S, Ware Shoals, SC 29692 | 2010-05-12 |
| 1629136858 | West End Drug Inc | Pharmacist | 80 N Greenwood Ave, Ware Shoals, SC 29692 | 2006-12-04 |
| 1043229982 | Bennie S Henderson | Nurse Practitioner | 157 B S Greenwood Ave Ext, Ware Shoals, SC 29692 | 2006-08-07 |
| 1689858367 | Harmony Residential Care Center, LLC | Assisted Living Facility | 10 N Greenwood Ave, Ware Shoals, SC 29692-1239 | 2007-12-18 |
| 1104022516 | Park Pharmacy, Inc | Durable Medical Equipment & Medical Supplies | 9 E Main St, Ware Shoals, SC 29692-1301 | 2007-06-22 |
| 1679679138 | Park Pharmacy, Inc | Pharmacist | 9 E Main St, Ware Shoals, SC 29692-1301 | 2006-09-15 |
| 1699119263 | Alison M Richter | Psychologist | 25 E Main St, Ware Shoals, SC 29692-1338 | 2013-04-25 |
| 1215094230 | Charles Eugene Willard | Dentist | 27 E Main St, Ware Shoals, SC 29692-1338 | 2007-01-02 |
| Find all providers in zip 29692 | ||||
| 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 |
|---|---|---|---|---|
| 1235743295 | Kp and Rd LLC | Pharmacy | 721 N Greenwood Avenue, Ware Shoals, SC 29692 | 2020-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720535 | Detyens Medical Center | Pharmacy | 1670 Drydock Avenue, Building 10, Suite A, North Charleston, SC 29405 | 2020-11-03 |
| 1053918458 | Johns Island Pharmacy LLC | Pharmacy | 3133 Maybank Hwy, Johns Island, SC 29455-4838 | 2020-10-08 |
| 1821695735 | Msm Rx LLC | Pharmacy | 6323b N Main St, Columbia, SC 29203-4733 | 2020-10-04 |
| 1265045322 | Ptvp | Pharmacy | 8007 Warren H Abernathy Hwy, Spartanburg, SC 29301-2449 | 2020-08-28 |
| 1841801669 | Christmas Pharmacy LLC | Pharmacy | 1229 Alice Dr # B, Sumter, SC 29150-1970 | 2020-08-14 |
| 1639796022 | Wall Drugs of Pamplico, Inc. | Pharmacy | 616 S. Walnut Street, Pamplico, SC 29583 | 2020-07-01 |
| 1851913974 | Ebenezer Health Investors Inc | Pharmacy | 3217 Devine St, Columbia, SC 29205-1847 | 2020-05-12 |
| 1457971541 | Nephron Pharmacy LLC | Pharmacy | 4500 12th Street Ext Ste B, West Columbia, SC 29172-3025 | 2020-04-20 |
| 1770112849 | Fountain Inn Rx LLC | Pharmacy | 106 S Weston St, Fountain Inn, SC 29644-1940 | 2020-04-02 |
| 1033745112 | Charleston Oncology, Pa | Pharmacy | 300 Callen Blvd Ste 110, Summerville, SC 29486-2809 | 2020-03-20 |
| Find all providers with the same taxonomy | ||||
| City | WARE SHOALS |
| Zip Code | 29692 |
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.