Organization
K-VA-T FOOD STORES INC
Active
Other names
FOOD CITY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN C SMITH (PRESIDENT & CEO)
(276) 623-5100
Entity
Organization
Contact information
Practice address
603 WOOD AVE E, BIG STONE GAP, VA 24219-3021
(276) 523-6052
(276) 523-6153
Mailing address
PO BOX 1158, ABINGDON, VA 24212-1158
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
0201003995
VA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010101115
—
VA
01
—
010105692
VA MEDICAID DME
VA
01
—
145299
ANTHEM BCBS
—
01
—
4092130
BCBS OF TENNESSEE
TN
01
—
4582340
TENNCARE DME
TN
01
—
4838287
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
P00364986
RAILROAD MEDICARE
—
Enumeration date
07/15/2006
Last updated
04/22/2026
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