Freds Stores of Tennessee Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

50007616 Issued in SC

Legal business name

FREDS STORES OF TENNESSEE INC

Doing business as

Freds Pharmacy 2079

Practice address

198 Stuckey St
Johnsonville, SC 29555-6446

Phone

(843) 386-3335

Fax

(843) 386-3381

NPI assigned

Jul 7, 2006

Last updated

Jan 11, 2011By 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 PHARMACY 2079 Doing business as

Locations

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1386676229",
    "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": "198 STUCKEY ST",
            "city": "JOHNSONVILLE",
            "state": "SC",
            "postal_code": "295556446",
            "telephone_number": "843-386-3335",
            "fax_number": "843-386-3381"
        }
    ],
    "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": "2011-01-11",
        "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": "SC",
            "license": "50007616",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "50007616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4224995",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FREDS PHARMACY 2079",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Florence County School District Five
• Florence County School District Five
• Florence School District # 5
• Florence School District Five
• Florence School District Five
• Sharon M Haselden, RN
• Health Care Partners of South Carolina, Inc.
• Health Care Partners of South Carolina, Inc.
• Health Care Partners of South Carolina, Inc. (Health Care Partners Pharmacy-Johnsonville)
• Christine Shutter Hodges

• Community/Retail Pharmacy in Johnsonville, SC
• Providers in Johnsonville, 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 Jan 11, 2011; 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.