FREDS STORES OF TENNESSEE INC


Address: 5907 Old Mooringsport Road, Shreveport, LA 71107-2023
Phone: 9012382520

FREDS STORES OF TENNESSEE INC (NPI# 1104268390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104268390
Entity Type Organization
Organization Name FREDS STORES OF TENNESSEE INC
Other Organization Name FREDS PHARMACY 2679
Practice Address 5907 Old Mooringsport Road
Shreveport
LA 71107-2023
Mailing Address 4300 New Getwell Rd
Memphis
TN 38118-6801
Practice Telephone 9012382520
Mailing Fax Number 9013659820
Enumeration Date 2013-07-29
Last Update Date 2014-10-14
Authorized Official Name RICK CHAMBERS (VP)
Authorized Official Telephone 9012382477
Is Organization Subpart Y
Parent Organization Name FREDS INC
Parent Organization TIN

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
LA 2202332 05

Other Provider/Organization Names

Other Name Type Code
Freds Pharmacy 2679 Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 5907 OLD MOORINGSPORT ROAD
City SHREVEPORT
State LA
Zip Code 71107-2023

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1306490875 Kimber Leigh Lumley Registered Nurse 1440 Hawn Ave., Shreveport, LA 71107 2019-08-01
1871063461 Nicole Capito Case Manager/Care Coordinator 200 North Thomas Drive Ste 1, Shreveport, LA 71107 2018-11-27
1891260899 Danielle Leigh Dreher Dental Assistant 3610 Gorman Rd, Shreveport, LA 71107 2018-10-05
1255817540 Shirley Marie Washington Technician 3227 Old Mooringsport Rd., Shreveport Rd, LA 71107 2018-07-19
1366928467 Katrina L Bailey Case Manager/Care Coordinator 1111 Hawn Ave Apt A, Shreveport, LA 71107 2018-07-12
1063907970 James Mcneely IIi Public Health or Welfare 5922 Alaska Ln, Shreveport, LA 71107 2018-06-25
1528560067 Jacarie Guice Case Manager/Care Coordinator 4601 N. Market Ste 2, Shreveport, LA 71107 2018-03-01
1467971069 Tracy Renard Harris Counselor 1149 Englemeade Dr, Shreveport, LA 71107 2017-09-14
1427588045 Mark Rogers Behavior Technician 1500 N. Market Unit C Suite 105, Shreveport, LA 71107 2017-06-15
1356871164 Hope4youth Voluntary or Charitable 2850 King Oaks Loop, Shreveport, LA 71107 2017-06-14
Find all providers in zip 71107

Taxonomy Information

Taxonomy Code 3336C0003X
Grouping Suppliers
Classification Pharmacy
Specialization Community/Retail Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1689077430 University Health Shreveport LLC Pharmacy 1606 Kings Hwy Rm 2263, Shreveport, LA 71103-4128 2014-10-07
1619058468 Line Avenue Pharmacy Inc Pharmacy 1822 Line Ave, Shreveport, LA 71101-4612 2006-10-18
1215031141 Louisiana Cvs Pharmacy, L.L.C. Pharmacy 3300 Youree Dr, Shreveport, LA 71105-2116 2006-09-12
1033213962 Louisiana Cvs Pharmacy, L.L.C. Pharmacy 9194 Mansfield Rd, Shreveport, LA 71118-3123 2006-09-12
1497760664 Walgreen Co Pharmacy 3124 Line Ave, Shreveport, LA 71104-4240 2006-07-29
1023023298 Walgreen Co Pharmacy 6101 W 70th St, Shreveport, LA 71129-2507 2006-07-29
1235144411 Walgreen Co Pharmacy 3100 N Market St, Shreveport, LA 71107-4005 2006-07-29
1043225212 Walgreen Co Pharmacy 300 Southfield Rd, Shreveport, LA 71105-4112 2006-07-29
1134134307 Walgreen Co Pharmacy 3555 Greenwood Rd, Shreveport, LA 71109-5209 2006-07-29
1225043490 Walgreen Louisiana Co Inc Pharmacy 9209 Mansfield Rd, Shreveport, LA 71118-3152 2006-07-29
Find all providers in SHREVEPORT

Competitor

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City SHREVEPORT
Zip Code 71107

Improve Information

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Dataset Information

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.

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