FRED'S STORES OF TENNESSEE INC. (NPI# 1083088512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083088512 |
| Entity Type | Organization |
| Organization Name | FRED'S STORES OF TENNESSEE INC. |
| Other Organization Name | FRED'S PHARMACY 1219 |
| Practice Address |
1938 Main Street Cadiz KY 42211 |
| Mailing Address |
6625 Lenox Park Blvd. Suite 200 Memphis TN 38115 |
| Practice Telephone | 2705223211 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2019-08-30 |
| Authorized Official Name | JOSEPH ANTO (CEO) |
| Authorized Official Telephone | 9013623733 |
| 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 |
|---|---|---|---|
| KY | 7100386120 | 05 |
| Other Name | Type Code |
|---|---|
| Fred's Pharmacy 1219 | 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 |
| 1043684228 | Fred's Stores of Tennessee Inc. | Pharmacy | 1803 E Gentry Pkwy, Tyler, TX 75702-3564 | 2015-11-25 |
| 1053785238 | Fred's Stores of Tennessee Inc. | Pharmacy | 1123 State Highway 110 N, Whitehouse, TX 75791-3055 | 2015-11-25 |
| 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 |
1938 MAIN STREET |
| City | CADIZ |
| State | KY |
| Zip Code | 42211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063963676 | Ashleigh Dena Laffoon | Nurse Practitioner | 250 Main St Ste A, Cadiz, KY 42211 | 2016-10-18 |
| 1962849604 | Ronald Eugene Hoffman IIi | Dentist | 5269 Hopkinsville Rd, Cadiz, KY 42211 | 2013-06-03 |
| 1093056038 | Mary Sullivan Jolly | Nurse Practitioner | 250 Main Street, Suite E, Cadiz, KY 42211 | 2013-03-14 |
| 1770737728 | Trigg County Home Health, Inc. | Case Management | 1724 Canton Road, Cadiz, KY 42211 | 2008-11-04 |
| 1184824195 | Carla June Benbrook | Occupational Therapy Assistant | Shady Lawn, 2582 Cerulean Rd, Cadiz, KY 42211 | 2007-07-19 |
| 1508064965 | Michel Renee Vagts | Physical Therapist | 2582 Ceulean Rd, Cadiz, KY 42211 | 2007-07-06 |
| 1578680757 | Pennyrile District Health Department | Public Health or Welfare | 196 Main St., Cadiz, KY 42211 | 2007-03-23 |
| 1538257910 | Shea A. Godwin | Family Medicine | 250 Main St., Suite E, Cadiz, KY 42211 | 2006-10-10 |
| 1326424177 | Maanya LLC | Internal Medicine | 250 Main St, Suite A, Cadiz, KY 42211 | 2015-08-04 |
| 1144315771 | Catherine R Galla | Internal Medicine | 263 Main St, Cadiz, KY 42211 | 2006-10-03 |
| Find all providers in zip 42211 | ||||
| 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 |
|---|---|---|---|---|
| 1154478105 | Backel Corporation | Pharmacy | 241 South Main St, Cadiz, OH 43907 | 2007-01-04 |
| 1174090799 | Wisegroup LLC | Pharmacy | 289 Main St, Cadiz, KY 42211-9151 | 2018-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306445259 | Middletown Pharmacist Group | Pharmacy | 11601 Shelbyville Rd Ste B, Louisville, KY 40243-1309 | 2020-10-21 |
| 1144828724 | Pharmacy Care Center | Pharmacy | 10616 South Ky Hwy 15, Scuddy, KY 41760 | 2020-10-15 |
| 1497361208 | Kerry Hettinger | Pharmacy | 1114 Schiller Ave, Louisville, KY 40204-1946 | 2020-09-17 |
| 1114539822 | B&b Pharmacy, Pllc | Pharmacy | 126 Shadowmeade Lane, Unit 2, Mount Washington, KY 40047 | 2020-08-24 |
| 1376161588 | Arh Mary Breckinridge Health Services, Inc. | Pharmacy | 3504 West Cumberland Ave, Middlesboro, KY 40965-2612 | 2020-07-14 |
| 1073139531 | Cornerstone Care Associates | Pharmacy | 1509 1/2 Lexington Rd Ste 2, Richmond, KY 40475-1060 | 2020-06-21 |
| 1912523614 | Oldham Pharmacist Group | Pharmacy | 1000 Cherrywood Pl Ste 100, La Grange, KY 40031-8927 | 2020-06-18 |
| 1578187209 | St. Elizabeth Medical Center, Inc. | Pharmacy | 1 Medical Village Dr., Edgewood, KY 41017 | 2020-05-28 |
| 1922629997 | Classic Specialty Pharmacy Pllc | Pharmacy | 3582 Springhurst Blvd, Louisville, KY 40241-4141 | 2020-05-01 |
| 1346860095 | Dupont Pharmacy, LLC | Pharmacy | 3924 S Dupont Sq Ste D, Louisville, KY 40207-5912 | 2020-04-23 |
| 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.