FREDS STORES OF TENNESSEE, INC (NPI# 1033447586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033447586 |
Entity Type | Organization |
Organization Name | FREDS STORES OF TENNESSEE, INC |
Other Organization Name | FREDS PHARMACY 1359 |
Practice Address |
101 N Webster St Cuthbert GA 39840-2522 |
Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
Practice Telephone | 2297322893 |
Mailing Telephone | 9012382520 |
Mailing Fax Number | 9013659820 |
Enumeration Date | 2009-11-20 |
Last Update Date | 2011-08-10 |
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 | PHRE009631 | GA | Suppliers |
Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE009631 | GA | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NCPDP | 1159359 | 01 | |
GA | 572289729A | 05 |
Other Name | Type Code |
---|---|
Freds Pharmacy 1359 | Doing Business As Name - Organization |
Street Address |
101 N WEBSTER ST |
City | CUTHBERT |
State | GA |
Zip Code | 39840-2522 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972811297 | Heather Page | Pharmacist | 101 N Webster St, Cuthbert, GA 39840-2522 | 2010-09-21 |
1720424732 | William Hampton Ward IIi | Pharmacist | 101 N Webster St, Cuthbert, GA 39840-2522 | 2013-05-16 |
1811205065 | Leon Caldwell Patterson Jr. | Pharmacist | 101 N Webster St, Cuthbert, GA 39840-2522 | 2010-09-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366867533 | Rashema Vandetta Warren | Case Manager/Care Coordinator | 90 Villa Nova Street, New Horizons, Cuthbert, GA 39840 | 2014-02-25 |
1417378415 | Temperess Johnson | Adult Companion | 72 Cleborne Street, Cuthbert, GA 39840 | 2013-12-18 |
1730500976 | Mary Gibbs | Case Manager/Care Coordinator | 72 Clebourne Street, Cuthbert, GA 39840 | 2013-12-13 |
1023448917 | Katie Wright | Counselor | 72 Clebourne St, Cuthbert, GA 39840 | 2013-11-14 |
1588952048 | Michael Carr Jr. | Dentist | 84 Court Street, Cuthbert, GA 39840 | 2011-07-19 |
1518286764 | Lisa Ann Hardwick | Occupational Therapy Assistant | 2058 Hghway 82, Cuthbuert, GA 39840 | 2010-05-27 |
1952630154 | Naomi S Jenkins | Counselor | 264 Lumpkin Street, Cuthbert, GA 39840 | 2009-12-17 |
1467647875 | Mental Retardation Waiver Program | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 119 Claborn St., Cuthbert, GA 39840 | 2007-09-10 |
1376614073 | Randolph County Coutny School System | Local Education Agency (LEA) | 3451 Ga Hwy 266, Cuthbert, GA 39840 | 2006-11-13 |
1437632890 | Gary Nell Glover | Community Health Worker | 72 Clebourne Street, Cuthbert, GA 39840 | 2018-09-12 |
Find all providers in zip 39840 |
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 |
---|---|---|---|---|
1992354922 | Adams Family Pharmacy, Too, Inc | Pharmacy | 98 Peachtree St, Cuthbert, GA 39840-5807 | 2019-09-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154922441 | Southern Pharmacy Group LLC | Pharmacy | 110 Allison St., Jesup, GA 31545 | 2020-11-04 |
1184225526 | Svdp Georgia Community Pharmacy LLC | Pharmacy | 2050 Chamblee Tucker Rd Ste C, Chamblee, GA 30341-3343 | 2020-11-03 |
1194325860 | Panola Pharmacy LLC | Pharmacy | 2348 Panola Rd Unit C, Lithonia, GA 30058-5406 | 2020-10-30 |
1659971539 | Bob and Jeff's Hometown Pharmacy of Thomasville, LLC | Pharmacy | 309 Smith Ave, Thomasville, GA 31792-5534 | 2020-10-29 |
1679171979 | Dfg LLC | Pharmacy | 638 Historic Hwy 441 Suite A, Demorest, GA 30530 | 2020-10-09 |
1033716915 | Au Medical Center, Inc. | Pharmacy | 818 Saint Sebastian Way Ste 402, Augusta, GA 30901-2654 | 2020-10-05 |
1043817208 | Mlk Pharmacy2.0 | Pharmacy | 2457 Mlk Jr Dr Sw Ste A, Atlanta, GA 30311-1712 | 2020-10-01 |
1508470964 | Swain Drug Company LLC | Pharmacy | 855 Bowens Mill Rd Sw Suite E, Douglas, GA 31533 | 2020-09-03 |
1205446341 | Sunny Pharmacy | Pharmacy | 5364 Jonesboro Rd, Lake City, GA 30260-3557 | 2020-08-04 |
1841818044 | Hospital Authority of Miller County | Pharmacy | 213 Delores Street, Colquitt, GA 39837 | 2020-07-14 |
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.