FREDS STORES OF TENNESSEE INC (NPI# 1578616025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578616025 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 1839 |
| Practice Address |
80 Oak Street Hampton GA 30228 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 7709463901 |
| Practice Fax Number | 7709463904 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2013-05-08 |
| Authorized Official Name | MR. RICKY CHAMBERS (VP) |
| Authorized Official Telephone | 9012382477 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | Y |
| Parent Organization Name | FREDS INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE009116 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000367485F | 05 | |
| NCPDP | 1155185 | 01 |
| Other Name | Type Code |
|---|---|
| FREDS PHARMACY 1839 | 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 |
80 OAK STREET |
| City | HAMPTON |
| State | GA |
| Zip Code | 30228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679196166 | Mutinta Matimba Hamuwele | Nurse Practitioner | 10988 Genova Ter, Hampton, GA 30228 | 2020-05-19 |
| 1487295044 | Living Testimony Homecare, LLC | Home Health | 10833 Southwood Drive, Hampton, GA 30228 | 2019-10-04 |
| 1598246878 | Emma Ledbetter | Nurse Practitioner | 1910 Elm Park Dr, Hampton, GA 30228 | 2018-08-24 |
| 1720506231 | O'reilly Comprehensive Dermatology, Inc. | Dermatology | 755 Mount Vernon Hwy., Suite 330, Atlanta, GA 30228 | 2017-09-05 |
| 1720500648 | Sophia Demetria Edwards | Home Health Aide | 2059 Grove Way, Hampton, GA 30228 | 2017-07-12 |
| 1083143432 | Ciera Jayna Scales | Dentist | 144 Revolutionary Dr, Hampton, GA 30228 | 2017-06-08 |
| 1811446438 | Alwarna Pasteur | Contractor | 1419 Hyde Court, Hampton, GA 30228 | 2016-09-23 |
| 1932599370 | Corlyn Doolittle | Speech-Language Pathologist | 412 Lakeside Villa Dr, Lovejoy, GA 30228 | 2015-01-23 |
| 1114367596 | Mayer Counseling Services,llc | Counselor | 591 Toronto Circle, Hampton, GA 30228 | 2013-06-28 |
| 1932544269 | Eye Can See Eyewear Inc. | Technician/Technologist | 22 E. Main St. N., Hampton, GA 30228 | 2013-04-30 |
| Find all providers in zip 30228 | ||||
| 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 |
|---|---|---|---|---|
| 1932612736 | Cornerstone Rx | Pharmacy | 2100 Executive Dr Ste A, Hampton, VA 23666-2402 | 2017-11-15 |
| 1265944508 | Crwon Medical Inc. | Pharmacy | 695 Highway 3 N, Hampton, GA 30228-2832 | 2017-10-26 |
| 1700131927 | R & S Pharmacy | Pharmacy | 3321 W Mercury Blvd Ste D, Hampton, VA 23666-3806 | 2012-07-14 |
| 1366751752 | Victory Pharmacy Corporation | Pharmacy | 11328 Tara Blvd, Hampton, GA 30228-6229 | 2010-10-01 |
| 1982839916 | Virginia Cvs Pharmacy LLC | Pharmacy | 5001 Holt Ave, Hampton, VA 23666-2282 | 2009-05-20 |
| 1023173259 | R and D Apothecary, Inc | Pharmacy | 6 1st St Nw, Hampton, IA 50441-1902 | 2006-12-27 |
| 1528075553 | Walgreen Co | Pharmacy | 3326 W Mercury Blvd, Hampton, VA 23666-3807 | 2006-08-02 |
| 1902811953 | Walgreen Co | Pharmacy | 235 E Mercury Blvd, Hampton, VA 23669-2458 | 2006-07-29 |
| 1497772370 | Moyes Pharmacy Inc | Pharmacy | 34 E Main St S, Hampton, GA 30228-2930 | 2006-07-16 |
| 1225394760 | Beaufort Pharmacy and Compounding LLC | Pharmacy | 810 Elm St E, Hampton, SC 29924-2610 | 2012-04-10 |
| Find all providers in HAMPTON | ||||
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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.