Organization
K VA T FOOD STORES INC
Active
Other names
Food City Pharmacy #687
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN C SMITH (PRESIDENT & CEO)
(276) 623-5100
Entity
Organization
Contact information
Practice address
2712 LOVES CREEK RD., KNOXVILLE, TN 37924-2027
(865) 633-5008
(865) 525-5050
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
4306
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1455094
TENNCARE DME
TN
01
—
199890
ANTHEM BCBS
—
01
—
3913901
MEDICARE FLU SHOTS
—
01
—
4131388
BCBS OF TENNESSEE
TN
01
—
4439623
NCPDP
—
01
—
600002658
RAILROAD MEDICARE
—
Enumeration date
07/26/2006
Last updated
06/26/2014
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