NPIMap

Organization Active NPI

Freds Stores of Tennessee Inc

  • Community/Retail Pharmacy
  • Rome, GA
National Provider Identifier
1922030964
Registry record updated Jun 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE008909 Issued in GA
Legal business name
FREDS STORES OF TENNESSEE INC
Practice address
1916 Redmond Cir NW
Rome, GA 30165-1320
Phone
(706) 235-8828
Fax
(706) 235-7035
NPI assigned
Jul 7, 2006
Organization subpart
Yes
Parent organization
FREDS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 7, 2017

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

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHRE008909 GA
Community/Retail Pharmacy 3336C0003X PHRE008909 GA Primary

Addresses

Primary practice location

1916 Redmond Cir NW
Rome, GA 30165-1320

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
003181233AMedicaidGA
1152785OtherOTHER ID NUMBER-COMMERCIAL NUMBER
003139112AMedicaidGA

Other names 1

  • FREDS PHARMACY 2824 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": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496793600000",
    "number": "1922030964",
    "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": "1916 REDMOND CIR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651320",
            "telephone_number": "706-235-8828",
            "fax_number": "706-235-7035"
        }
    ],
    "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": "2017-06-07",
        "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": "GA",
            "license": "PHRE008909",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE008909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003181233A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1152785",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003139112A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FREDS PHARMACY 2824",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.