FREDS STORES OF TENNESSEE INC (NPI# 1720421597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720421597 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 3569 |
| Practice Address |
1128 Second Avenue Ne Fred's Pharmacy #3569 Fayette AL 35555-1739 |
| Mailing Address |
6625 Lenox Park Blvd. Suite 200 Memphis TN 38115 |
| Practice Telephone | 2059325400 |
| Practice Fax Number | 2059325401 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2019-12-06 |
| Authorized Official Name | RAHUL KULKARNI (SVP OF FINANCE) |
| Authorized Official Telephone | 8003747414 |
| 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 |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 148186 | 05 |
| Other Name | Type Code |
|---|---|
| Freds Pharmacy 3569 | 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 |
1128 SECOND AVENUE NE FRED'S PHARMACY #3569 |
| City | FAYETTE |
| State | AL |
| Zip Code | 35555-1739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982213021 | Brittany Nicole Pate | Pharmacist | 3186 Al-171 N, Fayette, AL 35555 | 2020-07-24 |
| 1942703020 | The Language Lab | Clinic/Center | 111 Columbus Street East, Fayette, AL 35555 | 2018-03-14 |
| 1407292709 | Lana Langley | Speech-Language Pathologist | 111 Columbus St E, Fayette, AL 35555 | 2013-05-14 |
| 1992096275 | Wendy Dawn Benton | Nurse Practitioner | 122 17th Court Ne, Fayette, AL 35555 | 2011-04-21 |
| 1699004929 | Patricia Lorraine Montgomery | Counselor | 123 2nd Avenue, Nw, Fayette, AL 35555 | 2009-12-16 |
| 1184826398 | Charles Thomas Webster | Pharmacist | 1116 2nd Ave Ne, Fayette Square Shopping Center, Fayette, AL 35555 | 2007-06-01 |
| 1114060381 | Fayette County Health Dept Adult Immun | Public Health or Welfare | 211 First Street, N.w., Fayette, AL 35555 | 2007-02-15 |
| 1356433064 | Dana Suzette Norris | Nurse Practitioner | 1653 Temple Ave N Ste 1, Fayette, AL 35555 | 2006-09-29 |
| 1992788871 | Air Evac Ems Inc | Ambulance | 108 21st St Ne, Fayette, AL 35555 | 2005-11-23 |
| 1255656112 | Debbie Kilgore Yerby | Pharmacist | 1716 Temple Avenue North, Fayette, AL 35555 | 2010-04-05 |
| Find all providers in zip 35555 | ||||
| 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 |
|---|---|---|---|---|
| 1114191459 | Fayette Pharmacy Inc | Pharmacy | 1128 2nd Ave Ne, Fayette, AL 35555-1739 | 2008-04-17 |
| 1316087703 | Bolling Pharmacy, Inc. | Pharmacy | 101 Temple Ave S, Fayette, AL 35555-2711 | 2007-02-07 |
| 1952952871 | Scpg Alabama LLC | Pharmacy | 1128 2nd Ave Ne, Fayette, AL 35555-1739 | 2019-09-23 |
| 1114401973 | Fayette Downtown Pharmacy, Inc | Pharmacy | 101 Temple Ave S, Fayette, AL 35555-2711 | 2018-09-18 |
| 1356796197 | C & D Pharmaceuticals Fayette Inc | Pharmacy | 106 16th St Ne, Fayette, AL 35555-1340 | 2016-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952909053 | Payne & Pitts, LLC | Pharmacy | 602 Alabama Avenue, Bridgeport, AL 35740-7513 | 2020-10-12 |
| 1366066144 | Jones Drugs LLC | Pharmacy | 3482 Crosswinds Dr, Phenix City, AL 36869 | 2020-06-08 |
| 1104448067 | Hh Health System - Retail Pharmacy LLC | Pharmacy | 201 Governors Dr Sw Ste 305, Huntsville, AL 35801-5170 | 2020-05-14 |
| 1609401678 | Pharmacy Investment Coordinators Inc | Pharmacy | 1301 Andrews Ave, Ozark, AL 36360-3717 | 2020-03-10 |
| 1861025520 | Monroe County Health Care Authority | Pharmacy | 2016 S Alabama Ave Ste D, Monroeville, AL 36460-3044 | 2020-02-20 |
| 1982235230 | Shiftrx Uab Mw, LLC | Pharmacy | 985 9th Ave Sw Ste 100, Bessemer, AL 35022-7810 | 2020-01-27 |
| 1316577943 | Gulf Health Management Services Inc | Pharmacy | 95 Shell St Ste 110, Saraland, AL 36571-2202 | 2020-01-23 |
| 1952931115 | Howard Pharmacy LLC | Pharmacy | 770a Pierce Rd, Mobile, AL 36608-9441 | 2020-01-16 |
| 1972144798 | Hh Health System - Marshall LLC | Pharmacy | 11491 Us Highway 431 Ste 1, Albertville, AL 35950-0136 | 2019-10-02 |
| 1275184517 | Avita Drugs Alabama, LLC | Pharmacy | 3220 5th Ave S, Birmingham, AL 35222-2309 | 2019-09-27 |
| Find all providers with the same taxonomy | ||||
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.