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FREDS PHARMACY
NPI 1902882426
Pharmacist in Schoolcraft, MI

Active since December 16, 2005CLIA 23D2139754 · Waiver
131 N GRAND ST, SCHOOLCRAFT, MI 49087(269) 679-4061(269) 679-4621 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Freds Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FREDS PHARMACY (NPI 1902882426) is a healthcare organization registered as a pharmacist in Schoolcraft, Michigan and active in the NPI registry since December 2005. The organization holds a CLIA Waiver certificate valid through November 7, 2027 and lists Frederick William Nelson, President Owner, as its authorized official.

NPPES Registry Identity

NPI1902882426
Entity TypeOrganization
Primary Taxonomy183500000X
Legal Business NameFREDS SUPER PHARMACY INC
Location Address131 N GRAND STSchoolcraft, MI 49087
Mailing AddressPo Box 396, 131 N Grand StSchoolcraft, MI 49087-0396 · (269) 679-4061 · Fax (269) 679-4621
Phone(269) 679-4061
Fax(269) 679-4621
Organization SubpartNo
Authorized OfficialFrederick William NelsonPresident Owner · (269) 649-0660
Enumeration DateDecember 16, 2005
Last NPPES UpdateAugust 22, 2020
✔ NPI 1902882426 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License✔ Licensed in MI · 5301003028
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
131 N GRAND ST, Schoolcraft, MI 49087
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Other Names 1

Doing Business AsFreds Pharmacy

Other Identifiers 1

Medicaid2529293MI

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2139754

Fred's Super-Pharmacy Inc · Vicksburg, MI
Active · expires Nov 7, 2027
CLIA Number23D2139754
Laboratory TypePharmacy
Certificate Effective DateNovember 8, 2025
Certificate Expiration DateNovember 7, 2027
Laboratory DirectorElaine A. Oestrike
Laboratory Phone(269) 649-0660
Laboratory LocationFred's Super-Pharmacy Inc121 W Prairie Street, Vicksburg, MI 49097
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Freds Super Pharmacy Inc's NPI number?

The NPI number for Freds Super Pharmacy Inc is 1902882426. It was assigned to this organization in the NPPES registry on December 16, 2005. The provider is doing business as Freds Pharmacy.

Where is Freds Super Pharmacy Inc located?

Freds Super Pharmacy Inc is located at 131 N Grand St, Schoolcraft, MI 49087. The listed phone number is (269) 679-4061.

What is Freds Super Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

Does Freds Super Pharmacy Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2139754) is associated with this NPI, valid through November 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Freds Super Pharmacy Inc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.