Organization
K VA T FOOD STORES INC
Active
Other names
Food City Pharmacy #662
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN C SMITH (CHAIRMAN PRESIDENT AND CEO)
(276) 623-5100
Entity
Organization
Contact information
Practice address
141 TOWN CENTRE DR, CROSSVILLE, TN 38571-7997
(931) 484-1368
(931) 456-5460
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
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1506087
TENN CARE CROSSOVER
TN
01
—
350202
MEDIGAP ANTHEM BCBS
—
01
—
4181392
BLUE CROSS BLUE SHIELD OF TN
TN
01
—
4441200
NCPDP
—
01
—
600002658
RAILROAD MEDICARE
—
Enumeration date
04/02/2008
Last updated
03/26/2024
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