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Contact Information

FREDS STORES OF TENNESSEE INC
80 OAK STREET
HAMPTON, GA30228
 Phone: 770-946-3901
 Fax: 770-946-3904
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for FREDS STORES OF TENNESSEE INC

NPI Number 1578616025
LBN Legal business name FREDS STORES OF TENNESSEE INC
Authorized official RICKY CHAMBERS - (VP)
Entity Organization
Organization subpart 1 Yes
Enumeration date 01/19/2007
Last updated 05/08/2013 - About 13 years ago
Identifiers
GA License # PHRE009116
GA Medicaid 000367485F
Other 1155185 NCPDP
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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