Freds Stores of Tennessee Inc
Organization Active NPI Community/Retail Pharmacy · Bowdon, GA
NPI 1740212786 · NPPES record last updated Jan 11, 2008
Key facts
- NPI
- 1740212786
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PHRE008991 (GA)
- Legal business name
- FREDS STORES OF TENNESSEE INC
- Practice address
- 85 Kidspeace Dr
Bowdon, GA 30108-3449 - Phone
- (770) 258-0158
- Fax
- (770) 258-0156
- NPI assigned
- Jul 7, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- FREDS INC
Authorized official
- Name
- Ricky Chambers, PHARMD
- Title
- VP
- Phone
- (901) 238-2477
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | PHRE008991 | GA | |
| Community/Retail Pharmacy | 3336C0003X | PHRE008991 | GA | Yes |
Addresses
Primary practice location
85 Kidspeace Dr
Bowdon, GA 30108-3449
Mailing address
4300 New Getwell Rd
Memphis, TN 38118-6801
Phone (901) 238-2520
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1153725 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names
- FREDS PHARMACY 1389
Other providers in Bowdon, GA
- Brian a Bain DDS PC
- Jimmy L. Brock
- Susan Cackowski
- Lynette Kay Conner
- Meranda Leigh Culpepper
- Jennifer Gaddie
- Georgia CVS Pharmacy LLC
- Emily Anna Gibbs
- Michelle Goldbach
- Michael Hanley
All providers in Bowdon, GA · Community/Retail Pharmacy in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.