FREDS STORES OF TENNESSEE INC (NPI# 1316979354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316979354 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 2176 |
| Practice Address |
301 Yazoo St Lexington MS 39095-3644 |
| Mailing Address |
6625 Lenox Park Blvd. Suite 200 Memphis TN 38115 |
| Practice Telephone | 6628343378 |
| Practice Fax Number | 6628343395 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2019-12-06 |
| Authorized Official Name | RAHUL KULKARNI (SVP OF FINANCE) |
| Authorized Official Telephone | 8003747417 |
| Is Organization Subpart | Y |
| Parent Organization Name | FREDS INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | 29101FL | MS | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
29101FL | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 0330144 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2518035 | 01 |
| Other Name | Type Code |
|---|---|
| FREDS PHARMACY 2176 | 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 |
301 YAZOO ST |
| City | LEXINGTON |
| State | MS |
| Zip Code | 39095-3644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882776 | Max Sanders | Pharmacist | 301 Yazoo St, Lexington, MS 39095-3644 | 2019-10-17 |
| 1952889255 | Jitney Pharmacies Inc | Pharmacy | 301 Yazoo St, Lexington, MS 39095-3644 | 2018-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295282358 | Mallory Community Health | Clinic/Center | 9749 Brozville Road, Lexington, MS 39095 | 2016-09-07 |
| 1336596170 | Telehealthone, LLC | Nurse Practitioner | 301 Yazoo Street, Lexington, MS 39095 | 2016-05-23 |
| 1740624881 | Mallory Community Health | Clinic/Center | 300 Yazoo Street, Lexington, MS 39095 | 2013-04-19 |
| 1912245671 | Ciera N Draine | Social Worker | Dr Arenia C Mallory Community Health Center, 17280 Highway 17 S, Lexington, MS 39095 | 2013-01-30 |
| 1184933384 | John D. Whitehead | Durable Medical Equipment & Medical Supplies | 22743 Hwy 12, Lexington, MS 39095 | 2010-10-05 |
| 1942536552 | Durant Primary Care Clinic | Clinic/Center | 22741 Bowling Green Rd, Lexington, MS 39095 | 2009-11-02 |
| 1205082963 | Heather Killebrew Tutor, Dmd, Pa | Dentist | 302 Court Square, Lexington, MS 39095 | 2008-08-13 |
| 1023145430 | Charles D Howard | Dentist | 102 Wall St, Lexington, MS 39095 | 2007-02-27 |
| 1619069622 | Charles Walton Campbell | Family Medicine | 102 Carrollton St, Lexington, MS 39095 | 2006-09-28 |
| 1972617876 | Lexington Primary Care | Clinic/Center | 110 Tchula Street, Lexington Primary Care, Lexington, MS 39095 | 2006-08-18 |
| Find all providers in zip 39095 | ||||
| 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 |
|---|---|---|---|---|
| 1477188464 | Redding Drug LLC | Pharmacy | 431 Redding Rd Ste 140, Lexington, KY 40517-2534 | 2020-03-10 |
| 1295372068 | Hometown Pharmacy of Lexington,pllc | Pharmacy | 2860 Richmond Rd Ste 190, Lexington, KY 40509-2766 | 2019-11-29 |
| 1447807458 | Saint Joseph Health System, Inc | Pharmacy | 1401 Harrodsburg Rd Ste B375, Lexington, KY 40504-3700 | 2019-08-23 |
| 1013490978 | Jason Lee Ratliff | Pharmacy | 740 South Limestone Street Room J-134, Lexington, KY 40536-0001 | 2018-09-07 |
| 1912433228 | Family Pharmacy LLC | Pharmacy | 4316 S Nc Highway 150, Lexington, NC 27295-5161 | 2017-05-05 |
| 1730564733 | Sunshine Pharmacy Services LLC | Pharmacy | 1856 S Lake Dr Ste K, Lexington, SC 29073-7225 | 2015-07-21 |
| 1184008435 | Your Care Pharmacy of Kentucky, LLC | Pharmacy | 3660 Rabbits Foot Trl, Unit 1, Lexington, KY 40503-3750 | 2015-07-16 |
| 1932532066 | Costco Wholesale Corporation | Pharmacy | 1500 Fitzgerald Ct Ste 100, Lexington, KY 40509 | 2013-08-13 |
| 1588007090 | Pharmacy Surge Unit #1 | Pharmacy | 808 Newtown Cir, Lexington, KY 40511-1230 | 2013-04-15 |
| 1255620464 | Broadway Clinic Pharmacy Inc | Pharmacy | 698 E New Circle Rd, Lexington, KY 40505-2948 | 2011-03-29 |
| Find all providers in LEXINGTON | ||||
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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.