NPIMap

Organization Active NPI

Freds Stores of Tennessee Inc

Doing business as Freds Xpress 3861

  • Community/Retail Pharmacy
  • Saint Joseph, LA
National Provider Identifier
1326065897
Registry record updated Dec 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5000 Issued in LA
Legal business name
FREDS STORES OF TENNESSEE INC
Doing business as
Freds Xpress 3861
Practice address
705 Plank Road Hwy 128
St. Joseph, LA 71366
Phone
(318) 766-4563
Fax
(318) 766-4522
NPI assigned
Jul 17, 2006
Last updated
Dec 5, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
FREDS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 5, 2019

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

Authorized official

Name
Rahul Kul Karni
Title
SVP of Finance
Phone
(800) 374-7417

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 5000 LA
Community/Retail Pharmacy 3336C0003X 5000 LA Primary

Addresses

Primary practice location

705 Plank Road Hwy 128
St. Joseph, LA 71366

Mailing address

6625 Lenox Park Blvd.
Suite 200
Memphis, TN 38115
Phone (901) 238-2520

Other identifiers 2

IdentifierTypeStateIssuer
1269743MedicaidLA
1930850OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • FREDS XPRESS 3861 Doing business as

National Provider Directory

National Provider Directory

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": "1575504000000",
    "number": "1326065897",
    "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": "705 PLANK ROAD HWY 128",
            "city": "ST. JOSEPH",
            "state": "LA",
            "postal_code": "71366",
            "telephone_number": "318-766-4563",
            "fax_number": "318-766-4522"
        }
    ],
    "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": "2019-12-05",
        "status": "A",
        "authorized_official_last_name": "KUL KARNI",
        "authorized_official_first_name": "RAHUL",
        "authorized_official_title_or_position": "SVP OF FINANCE",
        "authorized_official_telephone_number": "800-374-7417"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "LA",
            "license": "5000",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "5000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1269743",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1930850",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FREDS XPRESS 3861",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FREDS XPRESS 3861",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Joseph, LA

Sources for this page

  • 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.