NPIMap

Organization Active NPI

K-VA-T Food Stores Inc

Doing business as Food City Pharmacy #773

  • Community/Retail Pharmacy
  • Ooltewah, TN
National Provider Identifier
1295102986
Registry record updated Jan 9, 2026
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 #773
Practice address
1667 Ooltewah Ringgold Rd
Ooltewah, TN 37363-9830
Phone
(423) 893-1917
Fax
(423) 893-6276
NPI assigned
Aug 28, 2015
Last updated
Jan 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

1667 Ooltewah Ringgold Rd
Ooltewah, TN 37363-9830

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
Q021825OtherTNMEDICAID DME
Q021825OtherTNNONDME

Other names 1

  • Food City Pharmacy #773 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050302000805 TN Part B Supplier - Mass Immunization (Roster Biller Only) 8527011444 This NPI is an additional NPI on the enrollment
O20160211000791 TN DME Supplier - Pharmacy 8527011444 Practice locations: Ooltewah, TN

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
K-VA-T Food Stores Inc1667 Ooltewah Ringgold Rd, Ooltewah, TN 37363-9830(423) 893-1917 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|Surgical D… 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 24

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

View all 24

Locations

1667 Ooltewah Ringgold Rd
Ooltewah, TN 37363
Phone (423) 893-6160

NPI Registry JSON

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

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767916800000",
    "number": "1295102986",
    "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": "1667 OOLTEWAH RINGGOLD RD",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373639830",
            "telephone_number": "423-893-1917",
            "fax_number": "423-893-6276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K-VA-T FOOD STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-28",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHAIRMAN, PRESIDENT & CEO",
        "authorized_official_telephone_number": "276-623-5100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "Q021825",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONDME",
            "identifier": "Q021825",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Food City Pharmacy #773",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Food City Pharmacy #773",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ooltewah, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; 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.