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
2138 S MAYO TRL, PIKEVILLE, KY 41501-2296
(606) 432-2044
(606) 432-4587
Mailing address
PO BOX 1158, ABINGDON, VA 24212-1158
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
07048
KY
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180050
ANTHEM BCBS
—
01
—
1829069
NCPDP
KY
01
—
1829069
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
4107723
BCBS OF TENNESSEE
TN
05
—
54010418
—
KY
01
—
90011594
MEDICAID DME
KY
01
—
FLU0297
MEDICARE FLU SHOTS
—
01
—
P00339233
RAILROAD MEDICARE
—
Enumeration date
07/17/2006
Last updated
09/14/2007
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