Organization
K-VA-T FOOD STORES, INC
Active
Other names
Food City Pharmacy #743
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN C SMITH (PRESIDENT & CEO)
(276) 623-5100
Entity
Organization
Contact information
Practice address
2310 MCGRADY DRIVE, CLEVELAND, TN 37323
(423) 599-7053
(423) 790-0006
Mailing address
PO BOX 1158, ABINGDON, VA 24212-1158
(276) 623-5100
(276) 623-5440
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5095
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4445397
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/19/2012
Last updated
01/14/2025
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