Organization
K-VA-T FOOD STORES INC
Active
Other names
Food City Pharmacy #773
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
1667 OOLTEWAH RINGGOLD RD, OOLTEWAH, TN 37363-9830
(423) 893-1917
(423) 893-6276
Mailing address
PO BOX 1158, ABINGDON, VA 24212-1158
(276) 623-5100
(276) 623-5440
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q021825
MEDICAID DME
TN
Enumeration date
08/28/2015
Last updated
01/09/2026
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