Organization
K VA T FOOD STORES INC
Active
Other names
Food City Pharmacy #616
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
11501 HARDIN VALLEY ROAD, KNOXVILLE, TN 37932-2316
(865) 692-5183
(865) 692-5223
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
05
—
1516907
—
TN
01
—
366756
ANTHEM BC BS
—
01
—
4221019
BCBS TN
TN
01
—
4442149
NCPDP
—
Enumeration date
02/11/2009
Last updated
06/26/2014
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