FREDS STORES OF TENNESSEE INC (NPI# 1902177389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902177389 |
| Entity Type | Organization |
| Organization Name | FREDS STORES OF TENNESSEE INC |
| Other Organization Name | FREDS PHARMACY 2644 |
| Practice Address |
4628 Highway 28 E Pineville LA 71360-7733 |
| Mailing Address |
4300 New Getwell Rd Memphis TN 38118-6801 |
| Practice Telephone | 3184277505 |
| Practice Fax Number | 3184421859 |
| Mailing Telephone | 9012382520 |
| Mailing Fax Number | 9013659820 |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2012-09-18 |
| Authorized Official Name | RICK CHAMBERS (VICE PRESIDENT) |
| Authorized Official Telephone | 9012382477 |
| Is Organization Subpart | Y |
| Parent Organization Name | FREDS INC |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2201280 | 05 |
| Other Name | Type Code |
|---|---|
| Freds Pharmacy 2644 | 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 |
4628 HIGHWAY 28 E |
| City | PINEVILLE |
| State | LA |
| Zip Code | 71360-7733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578110789 | Reneisha Armonii Roberts | Pharmacist | 3100 La-28, Pineville, LA 71360 | 2019-08-22 |
| 1396303145 | Tina Marie Lawhorn | Nurse Practitioner | 2945 Shreveport Hwy, Pineville, LA 71360 | 2019-06-05 |
| 1942773213 | Tioga Pharmacy LLC | Pharmacy | 5101 Shreveport Hwy, Pineville, LA 71360 | 2019-01-09 |
| 1649755497 | Jessica Wooten | Nurse Practitioner | 292 Jerry Lofton Rd, Pineville, LA 71360 | 2018-09-27 |
| 1215421995 | Elizabeth Simon-clark | Counselor | Central La State Hospital Unit 6 Meadows Lane, Pineville, LA 71360 | 2018-06-18 |
| 1982116497 | Dm Properties of Rapides, LLC | Radiology | 2705 Highway 28 E Ste B, Pineville, LA 71360 | 2017-10-25 |
| 1508384587 | Marion Patrick Hazelton I | Counselor | Pathways Red River Treatment Center, 242 West Shamrock Ave Unit 6 Melody Lane, Pineville, LA 71360 | 2017-08-30 |
| 1669902557 | Jessica Williams | Social Worker | Unit 6 Wing A Meadow Lane, Pineville, LA 71360 | 2017-06-14 |
| 1104365840 | Naomi Gates | Social Worker | 242 W Shamrock Unit 1, Pineville, LA 71360 | 2017-02-14 |
| 1861930224 | Sharon Humphrey | Counselor | 5400 Service Rd B206, Pineville, LA 71360 | 2017-02-06 |
| Find all providers in zip 71360 | ||||
| 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 |
|---|---|---|---|---|
| 1366900276 | Pineville Pharmacy | Pharmacy | 311 S Polk St Ste 80, Pineville, NC 28134-8631 | 2019-03-10 |
| 1942773213 | Tioga Pharmacy LLC | Pharmacy | 5101 Shreveport Hwy, Pineville, LA 71360 | 2019-01-09 |
| 1174040604 | Walgreen Co | Pharmacy | 448 Appalachian Hwy, Pineville, WV 24874 | 2017-08-25 |
| 1164789301 | Csam Enterprises, LLC | Pharmacy | 2971 Highway 28 E, Pineville, LA 71360-5716 | 2012-04-12 |
| 1144236647 | Walgreen Co | Pharmacy | 3100 Highway 28 E, Pineville, LA 71360-5702 | 2006-08-01 |
| 1881609063 | Walgreen Co | Pharmacy | 3400 Military Hwy, Pineville, LA 71360-4230 | 2006-07-29 |
| 1679116446 | Tjak Group LLC | Pharmacy | 114 N Pine St, Pineville, KY 40977-1647 | 2019-10-23 |
| 1982253613 | Bella Lasley LLC | Pharmacy | 308 S Pine St, Pineville, KY 40977-1735 | 2019-09-05 |
| 1043879885 | Pineville Community Health Center Inc | Pharmacy | 850 Riverview Ave, Pineville, KY 40977-1452 | 2019-06-06 |
| 1174013676 | Pineville Medical Center, LLC | Pharmacy | 850 Riverview Ave, Pineville, KY 40977-1452 | 2018-05-10 |
| Find all providers in PINEVILLE | ||||
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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.