Freds Stores of Tennessee Inc
Organization Active NPI Community/Retail Pharmacy · Magee, MS
NPI 1962434902 · NPPES record last updated Apr 30, 2012
Key facts
- NPI
- 1962434902
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 24031FM (MS)
- Legal business name
- FREDS STORES OF TENNESSEE INC
- Practice address
- 1700 Simpson Highway 49
Suite 1
Magee, MS 39111-4900 - Phone
- (601) 849-5380
- Fax
- (601) 849-5169
- 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 | 24031FM | MS | |
| Community/Retail Pharmacy | 3336C0003X | 24031FM | MS | Yes |
Addresses
Primary practice location
1700 Simpson Highway 49
Suite 1
Magee, MS 39111-4900
Mailing address
4300 New Getwell Rd
Memphis, TN 38118-6801
Phone (901) 238-2520
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0330058 | Medicaid | MS | |
| 2517552 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names
- FREDS PHARMACY 2231
Other providers in Magee, MS
- Family Health Care Clinic, Inc.
- Family Vision Clinic, Inc.
- Fast Pace Mississippi, PLLC
- Bailey Joe Ferguson
- Kelli S Fewell
- James Ladd Garner
- Jessica April Garner
- Gene Polks Inc
- Audrey Donna Ghatas
- Jonathan Adam Giangrosso
All providers in Magee, MS · Community/Retail Pharmacy in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2012. 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.