NPIMap

Organization Active NPI

K-VA-T Food Stores Inc

  • Community/Retail Pharmacy
  • Vonore, TN
National Provider Identifier
1942543871
Registry record updated Apr 10, 2020
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
2120 Highway 411
Vonore, TN 37885-2220
Phone
(423) 442-4501
Fax
(423) 442-4504
NPI assigned
Mar 28, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2020

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

2120 Highway 411
Vonore, TN 37885-2220

Mailing address

201 Trigg St # 24210
P.O. Box 1158
Abingdon, VA 24210-3435
Phone (276) 623-5100

Other identifiers 1

IdentifierTypeStateIssuer
489639OtherVAANTHEM BCBS

Other names 1

  • Food City Pharmacy #620 Other name

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
O20131219000447 TN DME Supplier - Pharmacy 8527011444 Practice locations: Vonore, 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 Inc2120 Highway 411, Vonore, TN 37885-2220(423) 442-4501 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 17

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

View all 17

Locations

201 Trigg St
Abingdon, VA 24210

NPI Registry JSON

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

{
    "created_epoch": "1364428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586476800000",
    "number": "1942543871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 TRIGG ST # 24210",
            "address_2": "P.O. BOX 1158",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242103435",
            "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": "2120 HIGHWAY 411",
            "city": "VONORE",
            "state": "TN",
            "postal_code": "378852220",
            "telephone_number": "423-442-4501",
            "fax_number": "423-442-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K-VA-T FOOD STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-28",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "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": "ANTHEM BCBS",
            "identifier": "489639",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Food City Pharmacy #620",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Food City Pharmacy #620",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vonore, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2020; 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.