NPIMap

Organization Active NPI

Fred's Stores of Tennessee Inc.

Doing business as Fred's Pharmacy

  • Community/Retail Pharmacy
  • Mabelvale, AR
National Provider Identifier
1528509239
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
FRED'S STORES OF TENNESSEE INC.
Doing business as
Fred's Pharmacy
Practice address
13907 High Rd
Mabelvale, AR 72103-3212
Phone
(501) 455-1086
Fax
(501) 455-4780
NPI assigned
Mar 14, 2017
Last updated
Mar 14, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
FRED'S INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Authorized official

Name
Betty Ngo
Title
VP Reimbursement Programs
Phone
(901) 481-0346

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

13907 High Rd
Mabelvale, AR 72103-3212

Mailing address

4300 New Getwell Rd
Memphis, TN 38118-6801
Phone (901) 238-2520

Other names 1

  • Fred's Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Freds Pharmacy25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489449600000",
    "number": "1528509239",
    "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": "13907 HIGH RD",
            "city": "MABELVALE",
            "state": "AR",
            "postal_code": "721033212",
            "telephone_number": "501-455-1086",
            "fax_number": "501-455-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED'S STORES OF TENNESSEE INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRED'S INC.",
        "enumeration_date": "2017-03-14",
        "last_updated": "2017-03-14",
        "status": "A",
        "authorized_official_last_name": "NGO",
        "authorized_official_first_name": "BETTY",
        "authorized_official_title_or_position": "VP REIMBURSEMENT PROGRAMS",
        "authorized_official_telephone_number": "901-481-0346"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fred's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mabelvale, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.