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FREDS STORES OF TENNESSEE INC NPI 1316979347


NPI Information

NPI: 1316979347
Provider Name: FREDS STORES OF TENNESSEE INC

Doing Business As: FREDS PHARMACY 1881

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
2 FOREST PARK DR
HOLIDAY ISLAND, AR
ZIP 72631
Phone: (479) 253-7062
Get Directions

FREDS STORES OF TENNESSEE INC is a community/retail pharmacy pharmacy in Holiday Island, AR. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. FREDS STORES OF TENNESSEE INC NPI is 1316979347. The provider is registered as an organization entity type.
The provider Is Doing Business As Freds Pharmacy 1881.

The provider's business location address is:

2 FOREST PARK DR
HOLIDAY ISLAND, AR
ZIP 72631-229
Phone: (479) 253-7062
Fax: (479) 253-7509

The provider's authorized official is Rahul Kulkarni .
The authorized official title is Svp Of Finance and has the following contact phone number (800) 374-7417.

The enumeration date for this NPI number is 7/7/2006 and was last updated on 12/6/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacy419526ARKANSASNo
23336C0003XPharmacyCommunity/Retail Pharmacy419526ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1179664716OTHERARKANSASDME
21316979347MEDICAIDMISSOURI
30419526OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
4130603407MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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