NPIMap

Organization Active NPI

Freds Stores of Tennessee Inc

Doing business as Freds Xpress 3516

  • Community/Retail Pharmacy
  • Brookesville, MS
National Provider Identifier
1104843671
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5847012 Issued in MS
Legal business name
FREDS STORES OF TENNESSEE INC
Doing business as
Freds Xpress 3516
Practice address
25 Main Street
Brookesville, MS 39739
Phone
(662) 738-5878
Fax
(662) 738-4888
NPI assigned
Jul 17, 2006
Last updated
Dec 4, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
FREDS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Authorized official

Name
Ricky Chambers, PHARMD
Title
VP
Phone
(901) 238-2477

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 5847012 MS
Community/Retail Pharmacy 3336C0003X 5847012 MS Primary

Addresses

Primary practice location

25 Main Street
Brookesville, MS 39739

Mailing address

4300 New Getwell Rd
Memphis, TN 38118-6801
Phone (901) 238-2520

Other names 1

  • FREDS XPRESS 3516 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Freds Pharmacy25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1104843671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 NEW GETWELL RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381186801",
            "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": "25 MAIN STREET",
            "city": "BROOKESVILLE",
            "state": "MS",
            "postal_code": "39739",
            "telephone_number": "662-738-5878",
            "fax_number": "662-738-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDS STORES OF TENNESSEE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FREDS INC",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "CHAMBERS",
        "authorized_official_first_name": "RICKY",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "901-238-2477",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MS",
            "license": "5847012",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "5847012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FREDS XPRESS 3516",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.