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Organization

K VA T FOOD STORES INC

Active
Other names
Food City Pharmacy #650
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
300 MARKET DRIVE, LENOIR CITY, TN 37771
(865) 986-7032
(865) 986-8991
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
01
1509480
TENNCARE CROSSOVER
TN
01
359315
ANTHEM BCBS MEDIGAP
01
4202402
BLUE CROSS BLUE SHIELD OF TN
TN
01
4441832
NCPDP
01
600002658
RAILROAD MEDICARE
TN
Enumeration date
10/16/2008
Last updated
01/21/2009
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