Freds Pharmacy 1201
LBN: Freds Stores Of Tennessee Inc
Freds Pharmacy 1201 is an health care organization with primary practice located at 1212 Military Rd , Benton AR 72015-2908. 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 (501) 778-2036, or through Chambers, Ricky via phone (901) 238-2477.
Contact Information
Primary practice address
1212 Military Rd
Benton AR 72015-2908
Phone: (501) 778-2036
Fax: (501) 778-6899
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | 417255 | Arkansas |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 417255 | Arkansas |
Profile Details
| NPI number | 1639107618 |
|---|---|
| LBN Legal business name | Freds Stores Of Tennessee Inc |
| DBA Doing business as | Freds Pharmacy 1201 |
| Authorized official | Chambers, Ricky PHARMD |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Jun 29th, 2006 |
| Last updated | Jan 4th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639107618 | NPPES |
| Arkansas | Other | 156772716 | DME |
| Arkansas | MEDICAID | 120515407 | DME |
| Arkansas | Other | 0417255 | DME |
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