Organization
K-VA-T FOOD STORES INC
Active
Other names
Food City Pharamcy #642, FOOD CITY PHARMACY
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
508 E TRI COUNTY BLVD, OLIVER SPRINGS, TN 37840-2018
(865) 435-1187
(865) 435-2110
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
3459
TN
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103164
ANTHEM BCBS
—
01
—
1454301
TENNCARE DME
TN
01
—
3130112
BCBS OF TENNESSEE
TN
01
—
3913901
MEDICARE FLU SHOTS
—
01
—
4433619
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
600002658
RAILROAD MEDICARE
—
Enumeration date
07/15/2006
Last updated
10/29/2025
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