Freds Pharmacy 3801

LBN: Freds Stores Of Tennessee Inc
Freds Pharmacy 3801 is an health care organization with primary practice located at 641 Delmas Ave , Pascagoula MS 39567-4226. 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 (228) 769-6362, or through Chambers, Ricky via phone (901) 238-2477.

Contact Information

Primary practice address
641 Delmas Ave Pascagoula MS 39567-4226
Phone: (228) 769-6362
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Chambers, Ricky PHARMD
Phone: (901) 238-2477

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 04529017 Mississippi
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1114234549
LBN Legal business name Freds Stores Of Tennessee Inc
DBA Doing business as Freds Pharmacy 3801
Authorized official Chambers, Ricky PHARMD
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 7th, 2010
Last updated Nov 5th, 2010 - about 14 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 1114234549 NPPES
Mississippi MEDICAID 04529017

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