Freds Stores of Tennessee Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

FREDS STORES OF TENNESSEE INC.

Practice address

600 Nuckolls Rd
Bolivar, TN 38008-1532

Phone

(731) 658-5207

NPI assigned

May 14, 2013

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 names 1

• Hudson Drug Store #3579 Doing business as

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575590400000",
    "number": "1265878557",
    "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": "600 NUCKOLLS RD",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380081532",
            "telephone_number": "731-658-5207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDS STORES OF TENNESSEE INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FREDS INC.",
        "enumeration_date": "2013-05-14",
        "last_updated": "2019-12-06",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hudson Drug Store #3579",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hudson Drug Store #3579",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Diyana Fisher, DNP, PMHNP-BC
• Eric Alan Folk, DPH
• John Franz
• Laura Rutherford Franz, D.PH.
• Freds Stores of Tennessee Inc
• Darvis Quinn Gallaher, PH. D.
• Holly Galloway, B.S.
• Rachel Elizabeth Garrity, M.S., CCC-SLP
• George W Walters Jr
• Dongmo Georgette Tekobo

• Community/Retail Pharmacy in Bolivar, TN
• Providers in Bolivar, TN by specialty
• Community/Retail Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.