MEDICARE: OCOEE PROFESSIONAL PHARMACY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336L0003X	Long Term Care Pharmacy	3922	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2093986	OTHER		PK

General Provider Information

NPI Number	:	1548202211
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCOEE PROFESSIONAL PHARMACY LLC

Provider Business Mailing Address
First Line	:	2311 PARKER ST NE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-3928
Country	:	US
Telephone Number	:	423-472-2121
Fax Number	:	423-472-6400

Provider Business Practice Location Address
First Line	:	2311 PARKER ST NE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-3928
Country	:	US
Telephone Number	:	423-472-2121
Fax Number	:	423-472-6400

Authorized Official
Title or Position	:	PHARMACIST
Name	:	JOE MOORE
Credential	:
Telephone Number	:	423-667-8532

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	06/01/2026

Similar Medicare Providers

1568395275 — JAMES WILLIAM MARSHALL DPT
Practice Location Address:

2399 PARKER ST NE STE C3
CLEVELAND, TN
37311-3928

Practice Phone: 423-697-8844
Practice Fax:

1346737699 — DONNA CHEEK
Practice Location Address:

2311 PARKER ST NE
CLEVELAND, TN
37311-3928

Practice Phone: 423-472-2121
Practice Fax: 423-472-6400

1033908090 — CHATTANOOGA ORTHOPAEDIC GROUP, PC
Practice Location Address:

2399 PARKER ST NE STE C3
CLEVELAND, TN
37311-3928

Practice Phone: 423-624-2696
Practice Fax: 423-622-6249

1063983070 — REBECCA TAYLOR CCC-SLP
Practice Location Address:

14410 TERRACE RD
CLEVELAND, OH
44112-3928

Practice Phone: 216-268-6610
Practice Fax:

1396621736 — WOODBINE DENTAL PLLC
Practice Location Address:

1815 STUART AVE NW
CLEVELAND, TN
37311-4374

Practice Phone: 423-504-9513
Practice Fax:

1922611649 — DR. ALEXANDER LEMONTE HARRIS I DDS
Practice Location Address:

1815 STUART AVE NW
CLEVELAND, TN
37311-4374

Practice Phone: 423-472-4621
Practice Fax:

Directions to “OCOEE PROFESSIONAL PHARMACY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.