NPIMap

Organization Active NPI

K -VA -T Food Stores Inc

Doing business as Food City Pharmacy #850

  • Community/Retail Pharmacy
  • Wytheville, VA
National Provider Identifier
1114503877
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
K -VA -T FOOD STORES INC
Doing business as
Food City Pharmacy #850
Practice address
155 W Lee Hwy
Wytheville, VA 24382
Phone
(276) 239-6132
Fax
(276) 335-2107
NPI assigned
Mar 23, 2021
Last updated
Jun 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Steven C Smith
Title
President & Ceo
Phone
(276) 623-5100

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

155 W Lee Hwy
Wytheville, VA 24382

Mailing address

PO Box 1158
Abingdon, VA 24212-1158
Phone (276) 623-5100

Other names 1

  • Food City Pharmacy #850 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070307000603 VA Part B Supplier - Mass Immunization (Roster Biller Only) 8527011444 22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Independence, VA; Lebanon, VA; Marion, VA; Pennington Gap, VA; Pulaski, VA; Radford, VA; Saint Paul, VA; Vansant, VA…
O20210615000645 VA DME Supplier - Pharmacy 8527011444 Practice locations: Wytheville, VA

Other NPIs on the same Medicare enrollment 21

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 21

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2305527Food City Pharmacy #850155 W Lee Hwy, Wytheville, VA 24382Certificate of waiverJun 2, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
K-VA-T Foot Stores Inc155 W Lee Hwy, Wytheville, VA 24382(276) 239-6132 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Orthoses: Off-The-Shelf|Ostomy Supplies|Urological Supplies|Enteral Nutrients|Nebulizer … Accepts assignmentParticipating since Nov 28, 2001

National Provider Directory

National Provider Directory
Tax ID family
Food City Pharmacy117 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Locations

155 W Lee Hwy
Wytheville, VA 24382
Phone (276) 239-6132

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623369600000",
    "number": "1114503877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1158",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242121158",
            "telephone_number": "276-623-5100",
            "fax_number": "276-623-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 W LEE HWY",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "24382",
            "telephone_number": "276-239-6132",
            "fax_number": "276-335-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K -VA -T FOOD STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "276-623-5100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Food City Pharmacy #850",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Food City Pharmacy #850",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wytheville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.