FREDS PHARMACY LLC (NPI# 1851769541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851769541 |
| Entity Type | Organization |
| Organization Name | FREDS PHARMACY LLC |
| Other Organization Name | FREDS GRANVILLE PHARMACY |
| Practice Address |
75 Quaker Street Granville NY 12832 |
| Practice Telephone | 5186423733 |
| Mailing Telephone | 5186423733 |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2015-09-11 |
| Authorized Official Name | FREDERICK DOLTZ (OWNER/SUPERVISING PHARMACIST) |
| Authorized Official Telephone | 5186423733 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
033911 | NY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2153978 | 01 |
| Other Name | Type Code |
|---|---|
| Freds Granville Pharmacy | Doing Business As Name - Organization |
| Street Address |
75 QUAKER STREET |
| City | GRANVILLE |
| State | NY |
| Zip Code | 12832 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013353796 | Bianca B. Bernard | Registered Nurse | 84 East Potter Avenue, Granville, NY 12832 | 2013-05-21 |
| 1659693166 | Courtney Alexis Washburn | Pharmacist | 116 Quaker St, Granville, NY 12832 | 2010-02-25 |
| 1720114564 | Arnold Small | Dentist | The Orchard Nursing and Rehabilitation Centre, 10421state Route40, Granville, NY 12832 | 2007-02-26 |
| 1609933423 | Granville Central School District | Local Education Agency (LEA) | 58 Quaker St, Granville, NY 12832 | 2007-01-02 |
| 1891880944 | Anne E Riker | Physician Assistant | 17 Madison Street, Granville, NY 12832 | 2006-10-04 |
| 1881186930 | Brandy Lee Wadsworth | Registered Nurse | 79 North St, Granville, NY 12832 | 2018-06-05 |
| 1184933475 | Elizabethtown Community Hospital | General Acute Care Hospital | 66 Park Street, Suite 100, Elizabethtown, NY 12832-0000 | 2010-10-04 |
| 1942653852 | Laurie Ann Dennison | Registered Nurse | 15 Pine St, Granville, NY 12832-1111 | 2016-07-15 |
| 1952873259 | Michelle Parbus | Physician Assistant | 24 Pine St, Granville, NY 12832-1127 | 2018-12-26 |
| 1710371539 | 73 North of Granville, Inc. | Custodial Care Facility | 73 North St, Granville, NY 12832-1136 | 2015-03-19 |
| Find all providers in zip 12832 | ||||
| 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] |
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| 1508841834 | Profesional Pharmacy Managers LLC | Pharmacy | 314 S Mccoy St, Granville, IL 61326-9333 | 2005-12-09 |
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| 1477151512 | 101 Rx Pharmacy Inc | Pharmacy | 101 Rx Pharmacy Inc, 9718 101st Ave, Ozone Park, NY 11416 | 2020-10-12 |
| 1043818289 | Xuwei Lin | Pharmacy | 8218 14th Ave, Brooklyn, NY 11228-3114 | 2020-10-10 |
| 1043817463 | Angella Samson | Pharmacy | 1346 Granville Payne Ave, Brooklyn, NY 11239-2103 | 2020-10-08 |
| 1366059792 | Community Healthcare Network Inc. | Pharmacy | 999 Blake Ave Fl 1, Brooklyn, NY 11208-3535 | 2020-09-29 |
| 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.