Freds Stores of Tennessee Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

4145RC Issued in LA

Legal business name

FREDS STORES OF TENNESSEE INC

Practice address

2021 W Airline Hwy
La Place, LA 70068-3031

Phone

(504) 652-0174

Fax

(985) 652-0637

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

Ricky Chambers, PHARMD

Title

VP

Phone

(901) 238-2477

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• FREDS PHARMACY 2171 Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leonard J. Bourgeois, RPH

  • Pharmacist
  • Laplace, LA
  • NPI 1073823340
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200009600000",
    "number": "1801828843",
    "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": "2021 W AIRLINE HWY",
            "city": "LA PLACE",
            "state": "LA",
            "postal_code": "700683031",
            "telephone_number": "504-652-0174",
            "fax_number": "985-652-0637"
        }
    ],
    "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": "2008-01-11",
        "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": "LA",
            "license": "4145RC",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "4145RC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1266728",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1928639",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FREDS PHARMACY 2171",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Firas Hijazi MD Apmc
• Carla Jean Fisher
• Danielle F Folse, M.ED., CCC-SLP
• Leslie W Foret
• Forevercare Resource Center
• Fresenius Medical Care Laplace, LLC
• G G Transport
• April Rachelle Gaddy
• Ciara Gardner
• Madeline M Gardner

• Community/Retail Pharmacy in La Place, LA
• Providers in La Place, 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 Jan 11, 2008; 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.