Organization
K-VA-T FOOD STORES INC
Active
Other names
Food City Pharmacy #747
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN C SMITH (CHAIRMAN, PRESIDENT & CEO)
(276) 623-5100
Entity
Organization
Contact information
Practice address
841 US 411 NORTH, ETOWAH, TN 37331
(423) 263-5481
(423) 263-5261
Mailing address
PO BOX 1158, ABINGDON, VA 24212-1158
(276) 623-5100
(276) 623-5440
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q021823
MEDICAID DME
TN
Enumeration date
08/24/2015
Last updated
11/04/2025
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