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 3774

Practice address

21361 Whyte Hardee Blvd.
Hardeeville, SC 29927

Phone

(843) 784-6222

Fax

(843) 784-6223

NPI assigned

Dec 9, 2011

Last updated

Sep 11, 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

Rick Chambers

Title

Vice President

Phone

(901) 238-2477

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Freds Pharmacy 3774 Doing business as

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347321600000",
    "number": "1255609871",
    "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": "21361 WHYTE HARDEE BLVD.",
            "city": "HARDEEVILLE",
            "state": "SC",
            "postal_code": "29927",
            "telephone_number": "843-784-6222",
            "fax_number": "843-784-6223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDS STORES OF TENNESSEE INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FREDS INC",
        "enumeration_date": "2011-12-09",
        "last_updated": "2012-09-11",
        "status": "A",
        "authorized_official_last_name": "CHAMBERS",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "901-238-2477"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "713653",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freds Pharmacy 3774",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Hardeeville, SC
• Providers in Hardeeville, SC by specialty
• Community/Retail Pharmacy in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.