K VA T FOOD STORES, INC. (NPI# 1124494455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124494455 |
| Entity Type | Organization |
| Organization Name | K VA T FOOD STORES, INC. |
| Other Organization Name | FOOD CITY PHARMACY #619 |
| Practice Address |
180 Rutledge Pike Blaine TN 37709-2416 |
| Mailing Address |
Po Box 1158 Abingdon VA 24212-1158 |
| Practice Telephone | 8659330762 |
| Practice Fax Number | 8659321704 |
| Mailing Telephone | 2766235100 |
| Mailing Fax Number | 2766235440 |
| Enumeration Date | 2015-08-21 |
| Last Update Date | 2016-06-15 |
| Authorized Official Name | MR. STEVEN C SMITH (CHAIRMAN, PRESIDENT & CEO) |
| Authorized Official Telephone | 2766235100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | MEDICAID DME | Q021827 | 01 |
| Other Name | Type Code |
|---|---|
| Food City Pharmacy #619 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760850085 | K Va T Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 820 Mission Ridge Rd, Rossville, GA 30741-4246 | 2015-09-03 |
| 1013383553 | K Va T Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 255 Ocoee Xing Nw, Cleveland, TN 37312-4872 | 2015-08-19 |
| 1780050443 | K Va T Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 6043 Relocation Way, Ooltewah, TN 37363-8828 | 2015-08-18 |
| 1679941991 | K Va T Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 531 Battlefield Pkwy, Fort Oglethorpe, GA 30742-3848 | 2015-09-03 |
| 1497123723 | K Va T Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 1287 N Glenwood Ave, Dalton, GA 30721-2603 | 2015-09-03 |
| 1295102986 | K Va T Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 1667 Ooltewah Ringgold Rd, Ooltewah, TN 37363-9830 | 2015-08-28 |
| 1922475615 | K Va T Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 6951 Lee Hwy, Chattanooga, TN 37421-2447 | 2015-08-28 |
| 1164898599 | K Va T Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 420 Market St Unit 3, Dayton, TN 37321-1639 | 2015-08-20 |
| 1497121768 | K Va T Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 5604 Hixson Pike, Hixson, TN 37343-3243 | 2015-08-20 |
| 1073989406 | K Va T Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 1600 E 23rd St, Chattanooga, TN 37404-5707 | 2015-08-20 |
| Street Address |
180 RUTLEDGE PIKE |
| City | BLAINE |
| State | TN |
| Zip Code | 37709-2416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093108250 | Julie Keese | Pharmacist | 180 Rutledge Pike, Blaine, TN 37709-2416 | 2015-03-12 |
| 1962020669 | Samantha Owens | Pharmacist | 180 Rutledge Pike, Blaine, TN 37709-2416 | 2020-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750841 | Andrews Physical Therapy - Blaine, LLC | Physical Therapist | 1240 Rutledge Pike, Blaine, TN 37709 | 2020-11-03 |
| 1255801809 | Tara Danielle Atkins | Registered Nurse | 180 Emory Rd, Blaine, TN 37709 | 2018-11-27 |
| 1669891248 | Tammy Gould | Nurse Practitioner | 1066 Rutledge Pike, Blaine, TN 37709 | 2014-04-10 |
| 1295228005 | Wanda Fay White | Nurse Practitioner | 586 Rutledge Pike, Blaine, TN 37709-2314 | 2018-06-07 |
| 1336386440 | Cherokee Health Systems | Psychologist | 880 Rutledge Pike, Blaine, TN 37709-2317 | 2009-01-12 |
| 1851909097 | Rachel Miriam Maskin | Student in an Organized Health Care Education/Training Program | 880 Rutledge Pike, Blaine, TN 37709-2317 | 2020-07-14 |
| 1225680010 | Andrea Maria Gorrondona | Student in an Organized Health Care Education/Training Program | 880 Rutledge Pike, Blaine, TN 37709-2317 | 2019-07-11 |
| 1568022168 | Whitley Paige Nicely | Registered Nurse | 880 Rutledge Pike, Blaine, TN 37709-2317 | 2019-06-17 |
| 1942863915 | Kelley Buell | Nurse Practitioner | 880 Rutledge Pike, Blaine, TN 37709-2317 | 2019-04-16 |
| 1366908717 | Joy Long-taylor | Licensed Practical Nurse | 880 Rutledge Pike, Blaine, TN 37709-2317 | 2019-02-11 |
| Find all providers in zip 37709 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932115573 | Walgreen Co | Pharmacy | 12480 Aberdeen St Ne, Blaine, MN 55449-4721 | 2006-08-01 |
| 1245339548 | Grand St Paul Cvs LLC | Pharmacy | 2357 108th Ln Ne, Blaine, MN 55449-5222 | 2006-09-22 |
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| 1033718317 | Rockvegas Enterprises Inc Dba Gateway Pharmacy | Pharmacy | 524 N Gateway Ave, Rockwood, TN 37854-2353 | 2020-10-19 |
| 1124626767 | Knoxville Rx Corp | Pharmacy | 10205 Kingston Pike Ste E, Knoxville, TN 37922-3285 | 2020-10-15 |
| 1073126181 | Off Center, LLC | Pharmacy | 910 Overton Plz, Livingston, TN 38570-1753 | 2020-08-28 |
| 1316557937 | Guardian Pharmacy of Tennessee Three, LLC | Pharmacy | 661 E Lane St Ste B, Shelbyville, TN 37160-3437 | 2020-08-07 |
| 1447860507 | Fph LLC | Pharmacy | 2200 N Central Ave, Humbolt, TN 38343 | 2020-08-04 |
| 1366069965 | Plaza Pharmacy LLC | Pharmacy | 3024 Covington Pike Ste 5, Memphis, TN 38128-5043 | 2020-06-30 |
| 1548886104 | Tumlin Rx, LLC | Pharmacy | 104 E Main Blvd, Church Hill, TN 37642-3724 | 2020-06-19 |
| 1366065278 | Life Well Pharmacy, LLC | Pharmacy | 2408 Susannah St Ste 3, Johnson City, TN 37601-1765 | 2020-05-27 |
| 1699398602 | Walgreen Co | Pharmacy | 262 Danny Thomas Pl Ste 100rx, Memphis, TN 38105-3678 | 2020-05-26 |
| 1053931881 | Jones & Joslin, Pllc | Pharmacy | 4249 Highway 411 Ste 5, Madisonville, TN 37354-1544 | 2020-04-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.