Organization
K VA T FOOD STORES INC
Active
Other names
Food City Pharmacy, Food City Pharmacy #632
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
2799 HIGHWAY 72 N, LOUDON, TN 37774-6458
(865) 458-5312
(865) 458-5371
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
—
1526857
TENNCARE DME CROSSOVER
TN
01
—
4309620
BCBS TENNESSEE
TN
01
—
442787
ANTHEM BC BS
—
01
—
4444523
NCPDP
—
Enumeration date
09/19/2011
Last updated
11/20/2018
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