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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
7202 MAYNARDVILLE HWY, KNOXVILLE, TN 37918-5740
(865) 922-9683
(865) 925-2595
Mailing address
PO BOX 1158, ABINGDON, VA 24212-1158

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3029
TN
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
103093
ANTHEM BCBS
01
1454319
TENNCARE DME
TN
01
3126078
BCBS OF TENNESSEE
TN
01
3913901
MEDICARE FLU SHOTS
01
4433556
NCPDP
Enumeration date
07/15/2006
Last updated
09/26/2007
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