Organization
K VA T FOOD STORES INC
Active
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
123 W HWY 25 70, DANDRIDGE, TN 37725-6401
(865) 484-0263
(865) 484-0769
Mailing address
PO BOX 1158, ABINGDON, VA 24212-1158
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
3844
TN
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1454299
TENNCARE DME
TN
01
—
3913901
MEDICARE FLU SHOTS
—
01
—
4050099
BCBS OF TENNESSEE
TN
01
—
4436172
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
461376
ANTHEM BCBS
—
01
—
600002658
RAILROAD MEDICARE
—
01
—
Q021888
TN DME NEW
TN
Enumeration date
07/17/2006
Last updated
06/23/2016
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