Freds Stores of Tennessee Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

FREDS STORES OF TENNESSEE INC.

Doing business as

Fred's Pharmacy 3722

Practice address

1603 Ringgold Ave
Coushatta, LA 71019-9084

Phone

(318) 932-5194

Fax

(318) 932-9507

NPI assigned

Jun 24, 2014

Last updated

Dec 11, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

FRED'S INC.As 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

• Fred's Pharmacy 3722 Doing business as

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Fred's Inc

  • Pharmacist
  • Greensburg, LA
  • NPI 1043680887
  NPPES parent name

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418256000000",
    "number": "1447665807",
    "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": "1603 RINGGOLD AVE",
            "city": "COUSHATTA",
            "state": "LA",
            "postal_code": "710199084",
            "telephone_number": "318-932-5194",
            "fax_number": "318-932-9507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDS STORES OF TENNESSEE INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRED'S INC.",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-12-11",
        "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": "2202871",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fred's Pharmacy 3722",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lindsay Hawthorne Dupree, DPT
• Claire Elise Endris
• Esther M. Holloway, M.D., Apmc
• Evolve Family Life Services LLC
• Melanie Paul Francis, PA-C
• Green Meadow Haven
• Shannon Stewart Gresham, M.S., L.A.C.
• Macy Guin
• Sarah Herbel, MD
• Richard David Holcombe, PT, OCS

• Community/Retail Pharmacy in Coushatta, LA
• Providers in Coushatta, LA by specialty
• Community/Retail Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.