NPI | 1982632949 |
---|---|
Doing Business As | FREDS PHARMACY 1064 |
Entity Type | Organization |
Authorized Contact | RICKY CHAMBERS VP 901-238-2477 |
Organization Subpart ? | Yes |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 035139RC) |
Additional Taxonomies | 333600000X Pharmacy (Licence: LA 035139RC) |
Enumeration Date | 2006-06-29 |
Last Update Date | 2008-01-09 |