Freds Stores of Tennessee Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

C1199 Issued in TN

Legal business name

FREDS STORES OF TENNESSEE INC

Practice address

3012 Highway 31 W
White House, TN 37188-8970

Phone

(615) 672-3763

Fax

(615) 672-9505

NPI assigned

Jul 15, 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 3

Addresses

Other identifiers 1

Other names 1

• FREDS PHARMACY 3326 Doing business as

Locations

Practitioners 2

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

• Carey Michael Allen, DPH

  • Pharmacist
  • White House, TN
  • NPI 1497063788
  NPD (past)
• Dan Paul Green, DPH

  • Pharmacist
  • White House, TN
  • NPI 1366747057
  NPD (past)

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253232000000",
    "number": "1922024595",
    "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": "3012 HIGHWAY 31 W",
            "city": "WHITE HOUSE",
            "state": "TN",
            "postal_code": "371888970",
            "telephone_number": "615-672-3763",
            "fax_number": "615-672-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDS STORES OF TENNESSEE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FREDS INC",
        "enumeration_date": "2006-07-15",
        "last_updated": "2009-09-18",
        "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": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "C1199",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TN",
            "license": "C1199",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "C1199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4432035",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FREDS PHARMACY 3326",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kyndall Farmer
• Fast Pace Medical Clinic PLLC
• Cynthia Sue, Bata Fisher, R.D.
• Zachary Foster
• Karen Fraser, BSPT
• Megan Kathleen French, MS, LPC-MHSP
• Jay Garrett, PHARMD
• Laura Garrett, APRN
• Michael A Giblin, PA-C
• Mary Gill, COTA

• All providers in White House, TN
• Community/Retail Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2009; 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.