Organization
K-VA-T FOOD STORES INC
Active
Other names
Food City Pharmacy #895, 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
205 RIVERBEND DRIVE, SUITE 102, PENNINGTON GAP, VA 24277-2916
(276) 546-6820
(276) 546-6897
Mailing address
PO BOX 1158, ABINGDON, VA 24212-1158
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
0201003908
VA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008519927
—
VA
01
—
009120581
VA MEDICAID DME
VA
01
—
4055731
BCBS OF TENNESSEE
TN
01
—
464704
ANTHEM BCBS
—
01
—
4837223
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
54005590
—
KY
01
—
7100177630
KY MEDICAID
KY
01
—
90007113
KY MEDICAID DME
KY
01
—
P00364986
RAILROAD MEDICARE
—
Enumeration date
07/15/2006
Last updated
12/18/2025
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