FREDS STORES OF TENNESSEE INC (NPI# 1124050158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124050158 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 2296 |
| Practice Address |
2695 State Highway 77 S Marion AR 72364-2369 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 8707395518 |
| Practice Fax Number | 8707395523 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2012-04-30 |
| 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 | 420145 | AR | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
420145 | AR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 0420430 | 01 | |
| AR | DME | 156774716 | 01 |
| AR | 135213407 | 05 |
| Other Name | Type Code |
|---|---|
| FREDS PHARMACY 2296 | 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 |
2695 STATE HIGHWAY 77 S |
| City | MARION |
| State | AR |
| Zip Code | 72364-2369 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356942320 | Freda Cunningham | Pharmacy | 2100 Hwy 77, Marion, AR 72364 | 2020-11-05 |
| 1083235998 | Lorenzo Soto | Specialist/Technologist | 444 Dogwood Cove, Marion, AR 72364 | 2020-05-01 |
| 1225663073 | Martha Hall | Technician | 144 Morningside Drive, Marion, AR 72364 | 2020-03-11 |
| 1073159984 | Angela Hamill | Nurse Practitioner | 924 Ar 77, Marion, AR 72364 | 2019-11-26 |
| 1346761251 | Ashlyn Brook Williams | Nurse Practitioner | 136 Block Street, Marion, AR 72364 | 2017-06-30 |
| 1447622873 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 2100 Highway 77, Marion, AR 72364 | 2015-10-26 |
| 1366828378 | Hilary Hartwig | Nurse Practitioner | 1139 Hwy 77, Marion, AR 72364 | 2015-08-03 |
| 1730575077 | Roadmaps To Recovery Counseling Services of Midsouth | Community/Behavioral Health | 162 W Military Road, Marion, AR 72364 | 2015-04-14 |
| 1144661141 | Heather Chapman | Physical Therapy Assistant | 2860 I 55 Service Rd Ste C, Marion, AR 72364 | 2013-07-08 |
| 1679919351 | Gladys Hampton | Counselor | 1227 Highway 77, Suite 2, Marion, AR 72364 | 2013-05-21 |
| Find all providers in zip 72364 | ||||
| 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 |
|---|---|---|---|---|
| 1356942320 | Freda Cunningham | Pharmacy | 2100 Hwy 77, Marion, AR 72364 | 2020-11-05 |
| 1548527757 | Medrelief Pharmacy LLC | Pharmacy | 2895 State Highway 77 S Ste 3, Marion, AR 72364-2371 | 2012-04-12 |
| 1528333689 | Marion Discount Drugs | Pharmacy | 5332 Dale Drive, Marion, MS 39342 | 2012-03-21 |
| 1992849764 | Johnny H Burns, T/a Marion Discont Pharmacy | Pharmacy | 134 Block St, Marion, AR 72364-1956 | 2007-02-16 |
| 1346344298 | Hook Superx LLC | Pharmacy | 4630 S Washington St., Marion, IN 46953-5350 | 2006-09-12 |
| 1912000662 | Kentucky Cvs Pharmacy, L.L.C. | Pharmacy | 307 Sturgis Rd, Marion, KY 42064-1240 | 2006-09-07 |
| 1164525804 | Virginia Cvs Pharmacy LLC | Pharmacy | 945 A N Main St, Marion, VA 24354 | 2006-09-07 |
| 1730282484 | Ohio Cvs Stores LLC | Pharmacy | 535 Delaware Ave, Marion, OH 43302-5051 | 2006-09-07 |
| 1699878652 | Marion Pharmacy Inc | Pharmacy | 103 East Main, Marion, MI 49665 | 2006-09-06 |
| 1063524908 | W & B Drugs Inc | Pharmacy | 119 N Baldwin Ave, Marion, IN 46952-3535 | 2006-08-31 |
| Find all providers in MARION | ||||
Please comment or provide details below to improve the information on FREDS STORES OF TENNESSEE INC.
| 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.