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
6710 MALONE CREEK DR, KNOXVILLE, TN 37931-3402
(865) 584-0115
(865) 584-6042
Mailing address
PO BOX 1158, ABINGDON, VA 24212-1158
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
3699
TN
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1454316
TENNCARE DME
TN
01
—
318978
ANTHEM BCBS
—
01
—
3913901
MEDICARE FLU SHOTS
—
01
—
4010823
BCBS OF TENNESSEE
TN
01
—
4435120
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
600002658
RAILROAD MEDICARE
—
Enumeration date
07/15/2006
Last updated
03/31/2021
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