MEDICARE: SUPER DISCOUNT PHARMACY

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	0000000248	TN
2	3336C0003X	Community/Retail Pharmacy

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	4417312	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1649296716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPER DISCOUNT PHARMACY

Provider Business Mailing Address
First Line	:	PO BOX 3240
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37320-3240
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2010 SPRING PLACE RD SE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37323-3337
Country	:	US
Telephone Number	:	423-472-2121
Fax Number	:	423-472-2169

Authorized Official
Title or Position	:	OWNER
Name	:	JOE MOORE
Credential	:	CPHT
Telephone Number	:	423-472-2121

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	09/11/2025

Similar Medicare Providers

1538220496 — COMMON ILLNESS CLINIC LLC
Practice Location Address:

2010 SPRING PLACE RD SE
CLEVELAND, TN
37323-3337

Practice Phone: 423-614-4780
Practice Fax:

1033117536 — MR. ALVIN M. SANDBERG R.PH.
Practice Location Address:

240 FLAGSTONE DR NE
CLEVELAND, TN
37323-5199

Practice Phone: 423-473-0225
Practice Fax:

1427037563 — MS. LEE ANN STABLER CNM
Practice Location Address:

286 LAMAR LAWSON RD NE
CLEVELAND, TN
37323-5311

Practice Phone: 423-716-0661
Practice Fax:

1427019116 — MR. TRACY VINCENT TERPSTRA LPC
Practice Location Address:

2189 APD 40 , SUITE #1
CLEVELAND, TN
37323-6597

Practice Phone: 423-559-3129
Practice Fax: 423-559-3129

1861430753 — JEFF HALL INC
Practice Location Address:

4867 HIGHWAY 411
CLEVELAND, TN
37323-5360

Practice Phone: 423-338-8000
Practice Fax: 423-338-8002

1548202815 — DR. MARLENE A. CATANESE MD
Practice Location Address:

1420 FRITZ STREET
CLEVELAND, TN
37323-1420

Practice Phone: 423-338-8995
Practice Fax: 423-338-8996

Directions to “SUPER DISCOUNT PHARMACY ” 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.