K-VA-T Food Stores Inc
Organization Active NPI Community/Retail Pharmacy · East Ridge, TN
NPI 1467828129 · NPPES record last updated Oct 21, 2025
Key facts
- NPI
- 1467828129
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- K-VA-T FOOD STORES INC
- Practice address
- 3636 Ringgold Rd
East Ridge, TN 37412-1265 - Phone
- (423) 622-7354
- Fax
- (423) 622-4710
- NPI assigned
- Aug 18, 2015
- Organization subpart
- No
Authorized official
- Name
- Mr. Steven C Smith
- Title
- Chairman, President & Ceo
- Phone
- (276) 623-5100
Corporate family (same tax ID) 24
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| K-VA-T Food Stores Inc |
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 assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050302000805 | TN | Part B Supplier - Mass Immunization (Roster Biller Only) | 8527011444 | This NPI is an additional NPI on the enrollment |
| O20160212001507 | TN | DME Supplier - Pharmacy | 8527011444 | Practice locations: East Ridge, TN |
National Provider Directory
- Tax ID family
- Food City Pharmacy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
3636 Ringgold Rd
East Ridge, TN 37412-1265
Mailing address
PO Box 1158
Abingdon, VA 24212-1158
Phone (276) 623-5100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q021814 | Other | TN | MEDICAID DME |
Other names
- Food City Pharmacy #710
Other providers in East Ridge, TN
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- Heather Hutcheson
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- Deangelo Laclarence Jelks
- Gregory Robert Joyner
- Marie Anne Kamrath
- Christina Eunan Kang
- Khodiyar Health LLC
- Joan Elizabeth Kramer
- Amy Dawn Latham
All providers in East Ridge, TN · Community/Retail Pharmacy in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.