FREDS STORES OF TENNESSEE INC


Address: 1590 4th St, Lewisport, KY 42351-2529
Phone: 2709223003

FREDS STORES OF TENNESSEE INC (NPI# 1841598067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1841598067
Entity Type Organization
Organization Name FREDS STORES OF TENNESSEE INC
Other Organization Name FREDS PHARMACY 3738
Practice Address 1590 4th St
Lewisport
KY 42351-2529
Mailing Address 4300 New Getwell Rd
Memphis
TN 38118-6801
Practice Telephone 2709223003
Practice Fax Number 2709222117
Mailing Telephone 9012382520
Mailing Fax Number 9013659820
Enumeration Date 2011-03-11
Last Update Date 2017-06-29
Authorized Official Name MRS. BETTY NGO (VP)
Authorized Official Telephone 9012383410
Is Organization Subpart Y
Parent Organization Name FREDS INC
Parent Organization TIN

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 332B00000X Durable Medical Equipment & Medical Supplies P07445 KY Suppliers
Y 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
KY 7100157980 05
IN 300001812 05

Other Provider/Organization Names

Other Name Type Code
Freds Pharmacy 3738 Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 1590 4TH ST
City LEWISPORT
State KY
Zip Code 42351-2529

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1437547312 Monica Montgomery I Occupational Therapy Assistant 8005 U.S. 60, Lewisport, KY 42351 2014-12-31
1467619247 Green River District Health Department Public Health or Welfare 80 State Route 271 South, Lewisport, KY 42351 2008-05-20
1720204969 Choctaw Brodie Badgett Dentist 8340 U.S. 60 West, Lewisport, KY 42351 2007-04-17
1326541988 Susan Renee Hicks Registered Nurse 1520 4th St, Lewisport, KY 42351 2018-03-09
1154748986 Ack Healthcare Management, LLC Nurse Practitioner 1520 4th St, Lewisport, KY 42351 2014-03-18
1932191335 Cynthia Jo Emmick Nurse Practitioner 8070 U.S. Hwy. 60 West, Lewisport, KY 42351-0078 2005-08-22
1689194987 Mckena Tichenor, LLC Counselor 1210 4th Street, Lewisport, KY 42351-2526 2017-06-27
1487632709 Jessica L Estes Nurse Practitioner 1210 4th St, Lewisport, KY 42351-2526 2006-01-06
1053912956 Behj Group LLC Nurse Practitioner 1210 4th St, Lewisport, KY 42351-2526 2020-11-05
1609412154 Whitehouse Behavioral Health Nurse Practitioner 1210 4th St, Lewisport, KY 42351-2526 2019-11-19
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Taxonomy Information

Taxonomy Code 3336C0003X
Grouping Suppliers
Classification Pharmacy
Specialization Community/Retail Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1306445259 Middletown Pharmacist Group Pharmacy 11601 Shelbyville Rd Ste B, Louisville, KY 40243-1309 2020-10-21
1144828724 Pharmacy Care Center Pharmacy 10616 South Ky Hwy 15, Scuddy, KY 41760 2020-10-15
1497361208 Kerry Hettinger Pharmacy 1114 Schiller Ave, Louisville, KY 40204-1946 2020-09-17
1114539822 B&b Pharmacy, Pllc Pharmacy 126 Shadowmeade Lane, Unit 2, Mount Washington, KY 40047 2020-08-24
1376161588 Arh Mary Breckinridge Health Services, Inc. Pharmacy 3504 West Cumberland Ave, Middlesboro, KY 40965-2612 2020-07-14
1073139531 Cornerstone Care Associates Pharmacy 1509 1/2 Lexington Rd Ste 2, Richmond, KY 40475-1060 2020-06-21
1912523614 Oldham Pharmacist Group Pharmacy 1000 Cherrywood Pl Ste 100, La Grange, KY 40031-8927 2020-06-18
1578187209 St. Elizabeth Medical Center, Inc. Pharmacy 1 Medical Village Dr., Edgewood, KY 41017 2020-05-28
1922629997 Classic Specialty Pharmacy Pllc Pharmacy 3582 Springhurst Blvd, Louisville, KY 40241-4141 2020-05-01
1346860095 Dupont Pharmacy, LLC Pharmacy 3924 S Dupont Sq Ste D, Louisville, KY 40207-5912 2020-04-23
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Competitor

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City LEWISPORT
Zip Code 42351

Improve Information

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Dataset Information

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.

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