Fred'S Pharmacy 2484

LBN: Freds Stores Of Tennessee Inc
Fred'S Pharmacy 2484 is an health care organization with primary practice located at 905 West Main Street , Marion IL 62959-1998. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Freds Stores Of Tennessee Inc can be contacted via phone (618) 998-1269, or through Chambers, Ricky via phone (901) 238-2477.

Contact Information

Primary practice address
905 West Main Street Marion IL 62959-1998
Phone: (618) 998-1269
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Chambers, Ricky PHARMD
Phone: (901) 238-2477

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 54015486 Illinois
Suppliers / Community/Retail Pharmacy 3336C0003X 54015486 Illinois

Profile Details

NPI number 1003848045
LBN Legal business name Freds Stores Of Tennessee Inc
DBA Doing business as Fred'S Pharmacy 2484
Authorized official Chambers, Ricky PHARMD
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 7th, 2006
Last updated Nov 5th, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003848045 NPPES
Other 1477935 OTHER ID NUMBER-COMMERCIAL NUMBER

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