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
28093 THOMPSON PLAZA HWY 119, S WILLIAMSON, KY 41503-4016
(606) 237-1175
(606) 237-7491
Mailing address
PO BOX 1158, ABINGDON, VA 24212-1158
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
06517
KY
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103153
ANTHEM BCBS
KY
01
—
1826138
NCPDP
KY
01
—
1826138
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
54000088
—
KY
05
—
85-00074000
—
WV
01
—
90002064
MEDICAID DME
KY
01
—
FLU0297
MEDICARE FLU
KY
01
—
P00339233
RAILROAD MEDICARE FLU
KY
Enumeration date
07/17/2006
Last updated
01/24/2019
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