Freds Stores of Tennessee Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

54014937 Issued in IL

Legal business name

FREDS STORES OF TENNESSEE INC

Doing business as

Freds Xpress 3936

Practice address

502 W Saint Louis St
West Frankfort, IL 62896-1957

Phone

(618) 932-3011

Fax

(618) 932-8401

NPI assigned

Jul 7, 2006

Last updated

Nov 5, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

FREDS INCAs reported in NPPES

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

Addresses

Other identifiers 1

Other names 1

• FREDS XPRESS 3936 Doing business as

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352073600000",
    "number": "1194757138",
    "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": "502 W SAINT LOUIS ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628961957",
            "telephone_number": "618-932-3011",
            "fax_number": "618-932-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDS STORES OF TENNESSEE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FREDS INC",
        "enumeration_date": "2006-07-07",
        "last_updated": "2012-11-05",
        "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": "IL",
            "license": "54014937",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "54014937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1475816",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FREDS XPRESS 3936",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Franklin Hospital District (West Frankfort Family Healthcare Clinic)
• Franklin Williamson Human Services
• Sydney Marie Frasier, L.S.W.
• Niki Loy Frassato-Welch, M.S/ED.
• Nathan Fred2
• Julie Kristen Freeman, P.T.
• Fresenius Medical Care West Frankfort Home, LLC
• Alexandria Frey
• Robin Lynn Gardner
• David John Giacone, PHARMACIST

• Community/Retail Pharmacy in West Frankfort, IL
• Providers in West Frankfort, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; 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.