Freds Stores of Tennessee Inc
Organization Active NPI Community/Retail Pharmacy · Amite, LA
NPI 1982632949 · NPPES record last updated Jan 9, 2008
Key facts
- NPI
- 1982632949
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 035139RC (LA)
- Legal business name
- FREDS STORES OF TENNESSEE INC
- Practice address
- 757 W Oak St
Amite, LA 70422-2734 - Phone
- (985) 748-6536
- Fax
- (985) 748-7286
- NPI assigned
- Jun 29, 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 | 035139RC | LA | |
| Community/Retail Pharmacy | 3336C0003X | 035139RC | LA | Yes |
Addresses
Primary practice location
757 W Oak St
Amite, LA 70422-2734
Mailing address
4300 New Getwell Rd
Memphis, TN 38118-6801
Phone (901) 238-2520
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1270971 | Medicaid | LA | |
| 1931131 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names
- FREDS PHARMACY 1064
Other providers in Amite, LA
- Jacey Busbice Fitzpatrick
- Labentria B Ford
- Frances Special Services, Inc
- Kali Franklin
- Christopher Frazier
- Kenneth Scott Fussell
- Genesis Partial Hospitalization
- Gentle Touch Provider LLC
- Gerald Anthony Giardina
- Christina Buonagura Givens
All providers in Amite, LA · Community/Retail Pharmacy in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 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.