Organization Name: | FREDS STORES OF TENNESSEE INC |
NPI Number: | 1093979213 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICKY CHAMBERS (VP) |
Mailing Address: | 821 South Main Street Church Point |
State: | LA US |
Postal Code: | 70525 |
Phone Number: | 3376841444 |
Fax Number: | 3376841448 |
NPI Enumeration Date: | 07/16/2008 |
NPI Last Update Date: | 10/22/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 6023-RC |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | LA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |