Organization Name: | FREDS STORES OF TENNESSEE INC |
NPI Number: | 1306964812 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICKY CHAMBERS (VP) |
Mailing Address: | 9574 Hwy 18 Vernon |
State: | AL US |
Postal Code: | 35592 |
Phone Number: | 2056951195 |
Fax Number: | 2056951196 |
NPI Enumeration Date: | 03/26/2007 |
NPI Last Update Date: | 09/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 112923 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AL |
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 |