NPIMap

Organization Active NPI

K VA T Food Stores Inc

  • Community/Retail Pharmacy
  • Morristown, TN
National Provider Identifier
1811205404
Registry record updated Feb 7, 2012
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
4100 Cool Springs Road
Morristown, TN 37814
Phone
(423) 317-5020
Fax
(423) 318-6999
NPI assigned
Sep 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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 3

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

Addresses

Primary practice location

4100 Cool Springs Road
Morristown, TN 37814

Mailing address

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

Other identifiers 5

IdentifierTypeStateIssuer
4277861OtherBLUE CROSS BLUE SHIELD OF TN
4443571OtherTNNCPDP
4277861OtherTNBC BS TN
1523264OtherTNTENNCARE CROSSOVER
414557OtherTNANTHEM BCBS

Other names 1

  • Food City Pharmacy #646 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
O20110406000454 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 Inc4100 Cool Springs Rd, Morristown, TN 37814-6693(423) 317-5020 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

4100 Cool Springs Rd
Morristown, TN 37814
Phone (423) 317-5020

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1284681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1811205404",
    "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": "4100 COOL SPRINGS ROAD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "37814",
            "telephone_number": "423-317-5020",
            "fax_number": "423-318-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K VA T FOOD STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-17",
        "last_updated": "2012-02-07",
        "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": "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TN",
            "identifier": "4277861",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4443571",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS TN",
            "identifier": "4277861",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNCARE CROSSOVER",
            "identifier": "1523264",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "414557",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Food City Pharmacy #646",
            "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 Feb 7, 2012; 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.