FREDS STORES OF TENNESSEE INC (NPI# 1881626828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881626828 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 1836 |
| Practice Address |
140 Trade Center Ln Hazlehurst MS 39083-2319 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 6018943008 |
| Practice Fax Number | 6018944864 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2007-11-29 |
| Authorized Official Name | 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 |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | 23641FH | MS | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
23641FH | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2517413 | 01 | |
| MS | 05776723 | 05 |
| Other Name | Type Code |
|---|---|
| FREDS PHARMACY 1836 | 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 |
140 TRADE CENTER LN |
| City | HAZLEHURST |
| State | MS |
| Zip Code | 39083-2319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235757949 | Claiborne Brooke White | Speech-Language Pathologist | 27190 Ms-28, Hazlehurst, MS 39083 | 2020-07-09 |
| 1750898961 | Laquita L. Johnson | Pharmacist | 102 Williams Street, Hazlehurst, MS 39083 | 2018-01-09 |
| 1134633324 | Enduracare Acute Care Services LLC | Clinic/Center | 236 North Caldwell Drive, Hazelhurst, MS 39083 | 2017-11-27 |
| 1053852392 | Alvin Dale Griffin | Occupational Therapy Assistant | 27190 Ms 28, Hazlehurst, MS 39083 | 2017-03-20 |
| 1770609364 | Gerri L Hill Chance | Psychiatry & Neurology | 206 Robert Mcdaniel Drive, Hazelhurst, MS 39083 | 2007-03-22 |
| 1902976665 | Allred's Pharmacy Inc | Pharmacy | 214 West Gallatin St, Hazelhurst, MS 39083 | 2006-11-09 |
| 1891897260 | Fred J Mcdonnell | Family Medicine | 213 Caldwell Drive, Hazlehurst, MS 39083 | 2006-09-05 |
| 1770515058 | Central Mississippi Civic Improvement Association | Clinic/Center | 550 Caldwell Drive, Hazlehurst, MS 39083 | 2006-07-07 |
| 1881649168 | Isd Renal Inc | Clinic/Center | 201 N Haley St, Hazlehurst, MS 39083 | 2006-05-24 |
| 1396793188 | Hazlehurst Vision Clinic | Optometrist | 247 North Caldwell Dr., Suite B, Hazlehurst, MS 39083 | 2006-05-04 |
| Find all providers in zip 39083 | ||||
| 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 |
|---|---|---|---|---|
| 1124179080 | Georgia Cvs Pharmacy LLC | Pharmacy | 92 S Tallahassee St, Hazlehurst, GA 31539-6157 | 2007-01-16 |
| 1548294705 | The Medicine of Hazlehurst LLC | Pharmacy | 63 E Jefferson St, Hazlehurst, GA 31539-6435 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164038485 | Quinn's Family Pharmacy of Newton | Pharmacy | 193 Northside Dr, Newton, MS 39345-9523 | 2020-09-22 |
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1649883844 | Natchez Wellness Pharmacy | Pharmacy | 29 Sergeant Prentiss Dr Ste 5, Natchez, MS 39120-4743 | 2020-08-26 |
| 1952910366 | Ct Stamps Inc | Pharmacy | 206 Marion Avenue, Mccomb, MS 39648 | 2020-07-31 |
| 1114566122 | Valley Drugs, Inc. | Pharmacy | 327b S Main St, Water Valley, MS 38965-3318 | 2019-12-23 |
| 1851939318 | Smith Pharmacy, Inc. | Pharmacy | 306 Northside Drive, Newton, MS 39345 | 2019-12-16 |
| 1285270801 | Proxsys Rx - Rush LLC | Pharmacy | 14916 Hwy 16 W, Unit #1, Dekalb, MS 39328 | 2019-11-19 |
| 1518501592 | Southwest Pharmacy Inc | Pharmacy | 3000 Plaza Dr Ste B, Tylertown, MS 39667-9227 | 2019-11-01 |
| 1669015210 | Hometown Family Pharmacy, Inc. | Pharmacy | 930 Hall St Ste H, Wiggins, MS 39577-2113 | 2019-10-25 |
| 1225671001 | A & A Infusion & Specialty, LLC | Pharmacy | 124 E Jackson St, Belzoni, MS 39038-3642 | 2019-10-23 |
| Find all providers with the same taxonomy | ||||
| City | HAZLEHURST |
| Zip Code | 39083 |
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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.