FREDS STORES OF TENNESSEE INC. (NPI# 1043659394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043659394 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC. |
| Other Organization Name | FREDS PHARMACY #3084 |
| Practice Address |
2110 Goodman Rd E Southaven MS 38672-9006 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 6623498505 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2014-01-03 |
| Authorized Official Name | RICK CHAMBERS (VICE PRESIDENT) |
| Authorized Official Telephone | 9012382477 |
| Is Organization Subpart | Y |
| Parent Organization Name | FREDS INC. |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09729057 | 05 |
| Other Name | Type Code |
|---|---|
| Freds Pharmacy #3084 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770906737 | Freds Stores of Tennessee Inc. | Pharmacy | 808 Nc Highway 69, Hayesville, NC 28904-9696 | 2014-01-28 |
| 1275963753 | Freds Stores of Tennessee Inc. | Pharmacy | 418 A West Central Avenue, Jamestown, TN 38556 | 2013-11-19 |
| 1548602758 | Freds Stores of Tennessee Inc. | Pharmacy | 11858 S Main St, Trenton, GA 30752 | 2013-07-29 |
| 1285970988 | Freds Stores of Tennessee Inc. | Pharmacy | 5751 Shed Rd, Bossier City, LA 71111 | 2012-12-27 |
| 1447524145 | Freds Stores of Tennessee Inc. | Pharmacy | 400 W. Mckinley Ave., Haughton, LA 71037-9449 | 2012-02-28 |
| 1255609871 | Freds Stores of Tennessee Inc. | Pharmacy | 21361 Whyte Hardee Blvd., Hardeeville, SC 29927 | 2011-12-09 |
| 1790053502 | Freds Stores of Tennessee Inc. | Pharmacy | 652 Hwy 365, Mayflower, AR 72106 | 2011-12-07 |
| 1013299080 | Freds Stores of Tennessee Inc. | Pharmacy | 306 Lamar St, Kilmichael, MS 39747-9732 | 2011-09-15 |
| 1588061394 | Freds Stores of Tennessee Inc. | Pharmacy | 214 S Main St, Fairmont, NC 28340-1904 | 2014-11-21 |
| 1104235316 | Freds Stores of Tennessee Inc. | Pharmacy | 211 South Main Street, Morgantown, KY 42261 | 2014-08-13 |
| Street Address |
2110 GOODMAN RD E |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38672-9006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871100826 | Sarah Kathryn Pratt | Physical Therapist | 5271 Getwell Road, Suite A, Southaven, MS 38672 | 2020-09-24 |
| 1356713606 | Deadra Dennis | Behavioral Analyst | 2816 Calico Rock Cv, Southaven, MS 38672 | 2015-10-27 |
| 1568727352 | Patricia Leanne Lewis | Family Medicine | 5908 Getwell Rd, Southaven, MS 38672 | 2012-07-09 |
| 1417183922 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2945 Goodman Road East, Southaven, MS 38672 | 2009-06-10 |
| 1568609998 | Susan Orsland | Physical Therapist | 4355 Genevieve Drive, Southaven, MS 38672 | 2009-01-07 |
| 1659516524 | Stacy L Sanders | Audiologist | 5740 Getwell Rd. Building 3 Unit B, Southaven, MS 38672 | 2008-12-08 |
| 1295927226 | Tracey F Petrides | Family Medicine | 5779 Getwell Road, Building D, Suite 3, Southaven, MS 38672 | 2007-08-14 |
| 1538288741 | Bruce A Denney | Dentist | 7125 Getwell Road, Suite 102, Southaven, MS 38672 | 2007-03-28 |
| 1154480150 | Kimberly Marie Metcalf | Social Worker | 7165-g Getwell Rd., Southaven, MS 38672 | 2006-12-06 |
| 1346318441 | Deborah Verucchi | Nurse Practitioner | 5740 Getwell Rd Ste B, Southaven, MS 38672 | 2006-11-30 |
| Find all providers in zip 38672 | ||||
| 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 |
|---|---|---|---|---|
| 1386918431 | Freds Stores of Tennessee Inc | Pharmacy | 710 Church Road, Southaven, MS 38671 | 2012-03-06 |
| 1184919268 | First Pharmacy Services 5 | Pharmacy | 5185a Getwell Rd, Southaven, MS 38671 | 2011-06-16 |
| 1073625075 | Pharm-care Inc | Pharmacy | 3449 Cobblestone Blvd S, Southaven, MS 38672-7075 | 2006-08-31 |
| 1295289650 | Sunil Malhotra Md LLC | Pharmacy | 470 Goodman Rd E, Southaven, MS 38671-9557 | 2016-08-15 |
| 1922285352 | Pinnacle Medical Solutions LLC | Pharmacy | 6856 Cobblestone Blvd, Southaven, MS 38672-9311 | 2008-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164038485 | Quinn's Family Pharmacy of Newton | Pharmacy | 193 Northside Dr, Newton, MS 39345-9523 | 2020-09-22 |
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1649883844 | Natchez Wellness Pharmacy | Pharmacy | 29 Sergeant Prentiss Dr Ste 5, Natchez, MS 39120-4743 | 2020-08-26 |
| 1952910366 | Ct Stamps Inc | Pharmacy | 206 Marion Avenue, Mccomb, MS 39648 | 2020-07-31 |
| 1114566122 | Valley Drugs, Inc. | Pharmacy | 327b S Main St, Water Valley, MS 38965-3318 | 2019-12-23 |
| 1851939318 | Smith Pharmacy, Inc. | Pharmacy | 306 Northside Drive, Newton, MS 39345 | 2019-12-16 |
| 1285270801 | Proxsys Rx - Rush LLC | Pharmacy | 14916 Hwy 16 W, Unit #1, Dekalb, MS 39328 | 2019-11-19 |
| 1518501592 | Southwest Pharmacy Inc | Pharmacy | 3000 Plaza Dr Ste B, Tylertown, MS 39667-9227 | 2019-11-01 |
| 1669015210 | Hometown Family Pharmacy, Inc. | Pharmacy | 930 Hall St Ste H, Wiggins, MS 39577-2113 | 2019-10-25 |
| 1225671001 | A & A Infusion & Specialty, LLC | Pharmacy | 124 E Jackson St, Belzoni, MS 39038-3642 | 2019-10-23 |
| 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.