Freds Stores of Tennessee Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

FREDS STORES OF TENNESSEE INC.

Doing business as

Freds Pharmacy 3726

Practice address

211 South Main Street
Morgantown, KY 42261

Phone

(270) 526-3332

Fax

(270) 526-3996

NPI assigned

Aug 13, 2014

Organization subpart

Yes

Parent organization

FREDS INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Rahul Kulkarni

Title

SVP of Finance

Phone

(800) 374-7417

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Freds Pharmacy 3726 Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575504000000",
    "number": "1104235316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 LENOX PARK BLVD.",
            "address_2": "SUITE 200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38115",
            "telephone_number": "901-238-2520",
            "fax_number": "901-365-9820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 SOUTH MAIN STREET",
            "city": "MORGANTOWN",
            "state": "KY",
            "postal_code": "42261",
            "telephone_number": "270-526-3332",
            "fax_number": "270-526-3996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDS STORES OF TENNESSEE INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FREDS INC.",
        "enumeration_date": "2014-08-13",
        "last_updated": "2019-12-05",
        "status": "A",
        "authorized_official_last_name": "KULKARNI",
        "authorized_official_first_name": "RAHUL",
        "authorized_official_title_or_position": "SVP OF FINANCE",
        "authorized_official_telephone_number": "800-374-7417"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100315950",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freds Pharmacy 3726",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Freds Pharmacy 3726",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chelsee Dalcourt
• Kerissa M Daughenbaugh, APRN
• Dexter Physical Therapy LLC
• Donna Jean Embry, APRN
• Family Options Inc
• Full Family Care, PLLC
• Full Urgent Care, PLLC
• Caitlyn Michelle Gary
• Zachery Scott Gary
• Ghayth Hammad MD

• Community/Retail Pharmacy in Morgantown, KY
• Providers in Morgantown, KY by specialty
• Community/Retail Pharmacy in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.