NPIMap

Organization Active NPI

K VA T Food Stores Inc

  • Community/Retail Pharmacy
  • Damascus, VA
National Provider Identifier
1477570950
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
K VA T FOOD STORES INC
Practice address
736 N Beaver Dam Rd
Damascus, VA 24236-2125
Phone
(276) 475-3653
Fax
(276) 475-5374
NPI assigned
Jul 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 0201003945 VA
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

736 N Beaver Dam Rd
Damascus, VA 24236-2125

Mailing address

PO Box 1158
Abingdon, VA 24212-1158

Other identifiers 8

IdentifierTypeStateIssuer
0497586MedicaidNC
4069625OtherTNBCBS OF TENNESSEE
4837817OtherNCPDP
4837817OtherOTHER ID NUMBER-COMMERCIAL NUMBER
010023068MedicaidVA
010023076OtherVAVA MEDICAID DME
463825OtherANTHEM BCBS
P00364986OtherRAILROAD MEDICARE

Other names 1

  • FOOD CITY PHARMACY 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…
O20100930006258 VA DME Supplier - Pharmacy 8527011444 Practice locations: Damascus, 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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
K -VA -T Food Stores Inc736 N Beaver Dam Ave, Damascus, VA 24236-2125(276) 475-3653 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 20

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

View all 20

Locations

736 N Beaver Dam Ave
Damascus, VA 24236
Phone (276) 475-3653

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403740800000",
    "number": "1477570950",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 N BEAVER DAM RD",
            "city": "DAMASCUS",
            "state": "VA",
            "postal_code": "242362125",
            "telephone_number": "276-475-3653",
            "fax_number": "276-475-5374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K VA T FOOD STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2014-06-26",
        "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"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "VA",
            "license": "0201003945",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0497586",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TENNESSEE",
            "identifier": "4069625",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4837817",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4837817",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010023068",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA MEDICAID DME",
            "identifier": "010023076",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "463825",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00364986",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOOD CITY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Damascus, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; 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.