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Contact Information

FREDS STORES OF TENNESSEE INC
7271 WALL TRIANA HWY
MADISON, AL35757
 Phone: 256-837-5522
 Fax: 256-837-6716
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for FREDS STORES OF TENNESSEE INC

NPI # 1649415902
LBN Legal business name FREDS STORES OF TENNESSEE INC
Authorized official RICKY CHAMBERSE - (VP)
Entity Organization
Organization subpart 1 Yes
Enumeration date 12/15/2008
Last updated 08/10/2009 - About 17 years ago
Identifiers
AL License # 113228
AL Medicaid 108365
Other 0135803 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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