Organization Active NPI

K VA T Food Stores Inc

Doing business as Food City Pharmacy

  • Community/Retail Pharmacy
  • Morristown, TN
National Provider Identifier
1508883950
Registry record updated Mar 5, 2015
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
Practice address
2310 Sandstone Drive
Unit 100
Morristown, TN 37814-3203
Phone
(423) 587-9792
Fax
(423) 587-6082
NPI assigned
Jul 15, 2006
Last updated
Mar 5, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2015

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 NU
Pharmacy 333600000X 3250 TN
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

2310 Sandstone Drive
Unit 100
Morristown, TN 37814-3203

Mailing address

PO Box 1158
Abingdon, VA 24212-1158

Other identifiers 7

IdentifierTypeStateIssuer
103176OtherANTHEM BCBS
3126087OtherTNBCBS OF TENNESSEE
1454309OtherTNTENNCARE DME CROSSOVER
3913901OtherMEDICARE FLU SHOTS
4433544OtherOTHER ID NUMBER-COMMERCIAL NUMBER
600002658OtherRAILROAD MEDICARE
4433544OtherNCPDP

Other names 1

  • FOOD CITY PHARMACY 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
O20100930053297 TN DME Supplier - Pharmacy 8527011444 Practice locations: Morristown, 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 Inc2310 Sandstone Dr, Morristown, TN 37814-2589(423) 587-9792 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 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

2310 Sandstone Dr
Unit 100
Morristown, TN 37814
Phone (423) 587-9792

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425513600000",
    "number": "1508883950",
    "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": "2310 SANDSTONE DRIVE",
            "address_2": "UNIT 100",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378143203",
            "telephone_number": "423-587-9792",
            "fax_number": "423-587-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K VA T FOOD STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2015-03-05",
        "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TN",
            "license": "3250",
            "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": "ANTHEM BCBS",
            "identifier": "103176",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TENNESSEE",
            "identifier": "3126087",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNCARE DME CROSSOVER",
            "identifier": "1454309",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE FLU SHOTS",
            "identifier": "3913901",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4433544",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "600002658",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4433544",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOOD CITY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Morristown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; 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.