Freds Stores of Tennessee Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

C3562 Issued in TN

Legal business name

FREDS STORES OF TENNESSEE INC

Practice address

5897 E Main St
Erin, TN 37061-4168

Phone

(931) 289-5995

Fax

(931) 289-5997

NPI assigned

Jul 7, 2006

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

Rahul Kulkarni

Title

SVP of Finance

Phone

(800) 374-7417

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• FREDS PHARMACY 1551 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": "1575590400000",
    "number": "1609808633",
    "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": "5897 E MAIN ST",
            "city": "ERIN",
            "state": "TN",
            "postal_code": "370614168",
            "telephone_number": "931-289-5995",
            "fax_number": "931-289-5997"
        }
    ],
    "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": "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": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "C3562",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "C3562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4434483",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FREDS PHARMACY 1551",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FREDS PHARMACY 1551",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Erin, TN
• Providers in Erin, 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.