FRED'S STORES OF TENNESSEE INC. (NPI# 1043684228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043684228 |
| Entity Type | Organization |
| Organization Name | FRED'S STORES OF TENNESSEE INC. |
| Other Organization Name | FRED'S PHARMACY #3081 |
| Practice Address |
1803 E Gentry Pkwy Tyler TX 75702-3564 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 9035331345 |
| Practice Fax Number | 9035331399 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2015-11-25 |
| Last Update Date | 2016-07-28 |
| Authorized Official Name | RICK CHAMBERS (VICE PRESIDENT) |
| Authorized Official Telephone | 9012382477 |
| Is Organization Subpart | Y |
| Parent Organization Name | FRED'S 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 |
|---|---|---|---|
| TX | 470912 | 05 |
| Other Name | Type Code |
|---|---|
| Fred's Pharmacy #3081 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497117881 | Fred's Stores of Tennessee Inc. | Pharmacy | 1550 S. Zach Hinton Parkway, Mcdonough, GA 30253 | 2016-03-24 |
| 1629443429 | Fred's Stores of Tennessee Inc. | Pharmacy | 620 E Franklin St Ste A, Sylvester, GA 31791-7189 | 2015-12-04 |
| 1053785238 | Fred's Stores of Tennessee Inc. | Pharmacy | 1123 State Highway 110 N, Whitehouse, TX 75791-3055 | 2015-11-25 |
| 1083088512 | Fred's Stores of Tennessee Inc. | Pharmacy | 1938 Main Street, Cadiz, KY 42211 | 2015-11-20 |
| 1346632460 | Fred's Stores of Tennessee Inc. | Durable Medical Equipment & Medical Supplies | 4401 Bemiss Rd, Valdosta, GA 31605-6049 | 2015-02-26 |
| 1639561756 | Fred's Stores of Tennessee Inc. | Pharmacy | 1442 Tift Ave N, Tifton, GA 31794-3545 | 2015-02-26 |
| 1023410727 | Fred's Stores of Tennessee Inc. | Pharmacy | 94 Upper Riverdale Rd Sw, Riverdale, GA 30274-2622 | 2014-09-24 |
| 1548662315 | Fred's Stores of Tennessee Inc. | Pharmacy | 1718 S Waukesha St, Bonifay, FL 32425-3114 | 2014-09-23 |
| 1750870192 | Fred's Stores of Tennessee Inc. | Pharmacy | 1801 Memorial Blvd, Murfreesboro, TN 37129-1522 | 2018-05-01 |
| 1528509239 | Fred's Stores of Tennessee Inc. | Pharmacy | 13907 High Rd, Mabelvale, AR 72103-3212 | 2017-03-14 |
| Street Address |
1803 E GENTRY PKWY |
| City | TYLER |
| State | TX |
| Zip Code | 75702-3564 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679116610 | Tiffiney Mcmakin | Nurse Practitioner | 810 E Houston St # 100, Tyler, TX 75702 | 2019-10-22 |
| 1659852507 | Krystal Gayle Lilley | Licensed Vocational Nurse | 100 E Ferguson St Ste 60a, Tyler, TX 75702 | 2018-08-28 |
| 1679029383 | Cynthia Lynn Kalawe | Physical Therapist | 100 E Ferguson, Suite 1204, Tyler, TX 75702 | 2016-09-01 |
| 1649623646 | Susan E Oxford | Social Worker | 13495 Frankston Highway, Tyler, TX 75702 | 2016-07-14 |
| 1053769281 | All Kidz Kan | Home Health | 2902 E Front St, Tyler, TX 75702 | 2016-05-27 |
| 1821415639 | Heather Mullins | Physical Therapy Assistant | 100 E. Ferguson Ste.1204, Tyler, TX 75702 | 2014-03-19 |
| 1346671336 | Dennis Keith Johnson | Dentist | 3081 Hwy. 31 East, Tyler, TX 75702 | 2013-12-02 |
| 1275882201 | Bobby Gibson | Counselor | 401 East Front Street, Ste 233, Tyler, TX 75702 | 2012-09-06 |
| 1144596792 | Tina Marie Borke | Clinical Neuropsychologist | 719 West Front St., Tyler, TX 75702 | 2012-03-28 |
| 1457629529 | James Whaley Rapp | Specialist/Technologist | 430 South Beckham Avenue, Trinity Mother Frances Sports Medicine, Tyler, TX 75702 | 2011-12-05 |
| Find all providers in zip 75702 | ||||
| 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 |
|---|---|---|---|---|
| 1508485871 | Tyler Carerx LLC | Pharmacy | 1007 E 2nd St, Tyler, TX 75701-3312 | 2020-04-15 |
| 1225498991 | Savrx Pharmacy, Inc | Pharmacy | 6100 S. Broadway Ave, Suite 160, Tyler, TX 75703 | 2016-02-24 |
| 1962874602 | Brookshire Grocery Company | Pharmacy | 172 Centennial Pkwy, Tyler, TX 75703 | 2015-10-21 |
| 1619143732 | Brookshire Grocery Company | Pharmacy | 1600 Wsw Loop 323, Tyler, TX 75701-8532 | 2008-05-08 |
| 1750485587 | Cvs Pharmacy Inc | Pharmacy | 4922 S Broadway Ave, Tyler, TX 75703-1324 | 2006-09-12 |
| 1235243221 | Majors Pharmacy Inc | Pharmacy | 108 Shelley Dr, Tyler, TX 75701-8723 | 2006-08-18 |
| 1700808458 | Cvs Pharmacy Inc | Pharmacy | 7003 S Broadway Ave, Tyler, TX 75703-4737 | 2006-07-24 |
| 1356955587 | American Specialty Pharmacy Inc | Pharmacy | 1109 E 5th St, Tyler, TX 75701-3318 | 2020-09-04 |
| 1336751270 | Stephenson Pharmacy, LLC | Pharmacy | 1000 S Fleishel Ave, Tyler, TX 75701-2037 | 2020-08-21 |
| 1326671397 | Hatrang Ho | Pharmacy | 1007 E 2nd St, Tyler, TX 75701-3312 | 2020-02-19 |
| Find all providers in TYLER | ||||
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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.