FREDS STORES OF TENNESSEE INC (NPI# 1730413311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730413311 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 1999 |
| Practice Address |
902 West Main St Homer LA 71040-3929 |
| Mailing Address |
6625 Lenox Park Blvd. Suite 200 Memphis TN 38115 |
| Practice Telephone | 3189276335 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2019-08-30 |
| Authorized Official Name | JOSEPH ANTO (CEO) |
| Authorized Official Telephone | 9013623733 |
| Is Organization Subpart | Y |
| Parent Organization Name | FREDS INC |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 6187 | LA | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
6187 | LA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1235326 | 05 | |
| NCPDP | 1934783 | 01 |
| Other Name | Type Code |
|---|---|
| Freds Pharmacy 1999 | 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 |
902 WEST MAIN ST |
| City | HOMER |
| State | LA |
| Zip Code | 71040-3929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609066646 | Homer Memorial Hospital | Nurse Anesthetist, Certified Registered | 620 East College St., Homer, LA 71040 | 2007-07-26 |
| 1881806164 | Southern Ingenuity Inc | Day Training, Developmentally Disabled Services | 598 Harmon Loop, Homer, LA 71040 | 2007-05-07 |
| 1104048214 | A and L of Northeast La Inc | Day Training, Developmentally Disabled Services | 911 West Main, Homer, LA 71040 | 2007-05-02 |
| 1356409619 | Southern Ingenuity Inc | Day Training, Developmentally Disabled Services | 3250 Hwy 79, Homer, LA 71040 | 2006-12-05 |
| 1851343529 | Claiborne Manor Nursing Home, LLC | Skilled Nursing Facility | 6942 Highway 79 North, Homer, LA 71040 | 2006-05-17 |
| 1679523807 | Larry Don Ezell | Emergency Medicine | 620 Ecollege Street, Homer, LA 71040 | 2006-05-10 |
| 1386856680 | Southern Ingenuity Inc | Day Training, Developmentally Disabled Services | 598 Harmon Loop, Homer, LA 71040 | 2007-05-07 |
| 1720290034 | Southern Ingenuity Inc | Day Training, Developmentally Disabled Services | 598 Harmon Loop, Homer, LA 71040 | 2007-05-07 |
| 1831137579 | Helen Denise Butler | Nurse Practitioner | 104 Morris Cir, Homer, LA 71040 | 2006-06-03 |
| 1245452234 | Melvin Harold Procell | Dentist | 5220 Highway 79, Homer, LA 71040-2002 | 2007-05-02 |
| Find all providers in zip 71040 | ||||
| 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 |
|---|---|---|---|---|
| 1396859286 | Ulmer Mede, Inc. | Pharmacy | 3858 Lake Street, Ste 5, Homer, AK 99603 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568054 | Chris Pharmacy of Gonzalez LLC | Pharmacy | 14505 Highway 44 Ste 112, Gonzales, LA 70737-7195 | 2020-11-02 |
| 1639779788 | Harvey Lee Smith Jr. | Pharmacy | 1707 Gardere Ln Ste F, Baton Rouge, LA 70820-8144 | 2020-10-28 |
| 1194331579 | Minden Family Pharmacy LLC | Pharmacy | 120 Homer Rd, Minden, LA 71055 | 2020-09-21 |
| 1093321812 | Community Pharmacy of Sterlington | Pharmacy | 200 Scott Dr, Sterlington, LA 71280 | 2020-09-17 |
| 1386256121 | Lagniappe Pharmacy 7, LLC | Pharmacy | 1900 Saint Charles Ave, New Orleans, LA 70130-5317 | 2020-08-22 |
| 1740890144 | Downtown Drugs Inc | Pharmacy | 338 N Vermont St, Covington, LA 70433-2812 | 2020-07-31 |
| 1053929703 | Viallon Drug Co of Donaldsonville | Pharmacy | 309 Marchand Dr, Donaldsonville, LA 70346-3242 | 2020-07-20 |
| 1619595584 | Brown's Pharmacy, LLC | Pharmacy | 1718 North Foster Drive, Suite B, Baton Rouge, LA 70806 | 2020-07-08 |
| 1417573593 | Doc Your Dose Pharmacy, LLC | Pharmacy | 17275 Hwy 77, Gross Tete, LA 70740 | 2020-06-24 |
| 1942829247 | Good Vibe Ventures LLC | Pharmacy | 5004 W Esplanade Ave Ste A, Metairie, LA 70006-2551 | 2020-04-16 |
| Find all providers with the same taxonomy | ||||
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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.