Organization
K-VA-T FOOD STORES INC
Active
Other names
Food City Pharmacy #620
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
2120 HIGHWAY 411, VONORE, TN 37885-2220
(423) 442-4501
(423) 442-4504
Mailing address
201 TRIGG ST # 24210, P.O. BOX 1158, ABINGDON, VA 24210-3435
(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
—
489639
ANTHEM BCBS
VA
Enumeration date
03/28/2013
Last updated
04/10/2020
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