FREDS STORES OF TENNESSEE INC (NPI# 1053343087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053343087 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 2806 |
| Practice Address |
3303 W Main Pl Skyline S/c Hwy 64 Russellville AR 72801-2334 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 4799683540 |
| Practice Fax Number | 4799686130 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2012-04-03 |
| 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 | 333600000X | Pharmacy | 417899 | AR | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
417899 | AR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | DME | 156726716 | 01 |
| AR | 122982407 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 0417899 | 01 |
| Other Name | Type Code |
|---|---|
| FREDS PHARMACY 2806 | 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 |
3303 W MAIN PL SKYLINE S/C HWY 64 |
| City | RUSSELLVILLE |
| State | AR |
| Zip Code | 72801-2334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518275080 | Dennis E Wheelus | Pharmacist | 3303 W Main Pl, Russellville, AR 72801-2334 | 2010-09-18 |
| 1659829828 | Jennifer Harrell | Pharmacist | 3303 W Main Pl, Russellville, AR 72801-2334 | 2016-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002782 | Randy Paul Stayton | Pharmacist | 2109 W Main, Russellville, AR 72801 | 2020-10-30 |
| 1871134825 | Just Spreading Love Senior Care LLC | Student in an Organized Health Care Education/Training Program | 1411 N. Pittsburg Avenue, Russellville, AR 72801 | 2019-10-01 |
| 1124670369 | Richard L Morgan Dds Pa | Dentist | 1700 West C Place, Russellville, AR 72801 | 2019-07-09 |
| 1407342371 | Andrew James Hickman | Optometrist | 2711 E Parkway Drive, Russellville, AR 72801 | 2018-07-03 |
| 1154859833 | Felicia Head | Speech-Language Pathologist | 220 W 10th St., Russellville, AR 72801 | 2017-05-25 |
| 1295281293 | Arkansas Liver and Gastroenterology, P.a. | Internal Medicine | 1605 West Main Street, Russellville, AR 72801 | 2016-08-30 |
| 1467802405 | Kah Development 4, LLC | Hospice Care, Community Based | 3801 W Main St Ste A, Russellville, AR 72801 | 2016-06-21 |
| 1871904839 | Sleep Partners, LLC | Clinic/Center | 1310 West B Street, Suite A, Russellville, AR 72801 | 2014-05-13 |
| 1942647029 | Rpi Sleep Complete LLC | Clinic/Center | 1310 West Main Street, Suite 201, Russellville, AR 72801 | 2013-05-29 |
| 1184967291 | Amedco Arkansas Pllc | Optometrist | 302 N. Phoenix Ave., Clark Eye Clinic, Russellville, AR 72801 | 2013-03-27 |
| Find all providers in zip 72801 | ||||
| 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 |
|---|---|---|---|---|
| 1902100530 | Franklin Pharmacy LLC | Pharmacy | 361 Mustang Dr, Russellville, AL 35654-8081 | 2010-12-21 |
| 1427384577 | Shoals Family Pharmacy Group Inc | Pharmacy | 318 Jackson Ave S, Suite 1, Russellville, AL 35653-2207 | 2009-10-26 |
| 1083787923 | Riley White Inc | Pharmacy | 153 Nw Park Sq, Russellville, KY 42276-1335 | 2006-11-16 |
| 1295831899 | C & D Drug Store Inc | Pharmacy | 121 N Commerce Ave, Russellville, AR 72801-3741 | 2006-09-15 |
| 1134617301 | Arkansas Cvs Pharmacy LLC | Pharmacy | 101 E Main St, Russellville, AR 72801 | 2018-04-24 |
| 1154667970 | Copeland Pharmaceutical Services LLC | Pharmacy | 14001 Highway 43, Ste 13, Russellville, AL 35653-2848 | 2012-12-26 |
| 1114938784 | Leighton Pharmacy Inc | Pharmacy | 14001 Highway 43, Ste 13, Russellville, AL 35653-2848 | 2006-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356942320 | Freda Cunningham | Pharmacy | 2100 Hwy 77, Marion, AR 72364 | 2020-11-05 |
| 1457978157 | Sc Pharmacy Group Opco LLC | Pharmacy | 1800 Riverfront Dr Ste 100, Little Rock, AR 72202-1882 | 2020-06-29 |
| 1790306124 | Jbr Enterprises Inc | Pharmacy | 600 Hwy 365, Mayflower, AR 72106 | 2020-04-27 |
| 1215557905 | Medman23, Inc | Pharmacy | 3201 Springhill Dr Ste 110, North Little Rock, AR 72117-2910 | 2020-04-22 |
| 1336768985 | Harps Food Stores, Inc | Pharmacy | 611 Highway 62 65 N, Harrison, AR 72601-2208 | 2020-04-14 |
| 1598393605 | Highlands Oncology Group Pa | Pharmacy | 3901 Parkway Circle, Springdale, AR 72762 | 2020-04-01 |
| 1326674870 | Caraway Drug L.l.c | Pharmacy | 106 W. State Street, Caraway, AR 72419 | 2020-03-17 |
| 1104461532 | Pruett's Food, Inc. | Pharmacy | 101 W. Main, Lockesburg, AR 71846 | 2019-11-08 |
| 1760025274 | Holiday Island Pharmacy, LLC | Pharmacy | 2 Forest Park Dr Ste A, Holiday Island, AR 72631-9229 | 2019-10-28 |
| 1730722463 | Beebe Family Pharmacy, LLC | Pharmacy | 1701 W Dewitt Henry Dr, Beebe, AR 72012-2024 | 2019-10-25 |
| Find all providers with the same taxonomy | ||||
| City | RUSSELLVILLE |
| Zip Code | 72801 |
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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.