FREDS STORES OF TENNESSEE INC.
NPI: 1306282827
· LAKE PROVIDENCE, LA 71254
· Community/Retail Pharmacy
· NPI assigned 05/13/2013
$214.56
Total Medicaid Paid
Provider Details
| Authorized Official | KULKARNI, RAHUL (SVP OF FINANCE) |
| Parent Organization | FREDS INC. |
| NPI Enumeration Date | 05/13/2013 |
Related Entities
Other providers sharing the same authorized official: KULKARNI, RAHUL
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
44 |
$214.56 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
44 |
40 |
$214.56 |