SUPERIOR MEDICAL SUPPLY, INC

Provider Demographics

• NPI: 1831192152
• Name: SUPERIOR MEDICAL SUPPLY, INC
• Entity type: Organization
• Organization Name: SUPERIOR MEDICAL SUPPLY, INC
• Other - Org Name: <UNAVAIL>
• Authorized Official - Title/Position: SR VICE PRESIDENT
• Authorized Official - First Name: SUE
• Authorized Official - Middle Name: ELLEN
• Authorized Official - Last Name: KAY
• Authorized Official - Phone: 888-588-9630
• Mailing Address - Street 1: PO BOX 922189
• Mailing Address - City: NORCROSS
• Mailing Address - State: GA
• Mailing Address - Zip Code: 30010-2189
• Mailing Address - Country: US
• Mailing Address - Phone: 866-449-4784
• Mailing Address - Fax: 888-835-3354
• Practice Address - Street 1: 6025 LEE HWY STE 320
• Practice Address - City: CHATTANOOGA
• Practice Address - State: TN
• Practice Address - Zip Code: 37421-2956
• Practice Address - Country: US
• Practice Address - Phone: 855-230-5632
• Practice Address - Fax: 931-551-8435
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2005-05-31
• Last Update Date: 2025-05-20

Provider Licenses

State	License ID	Taxonomies
TN	0000000615	332B00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	332B00000X	Suppliers	Durable Medical Equipment & Medical Supplies

Provider Identifiers

State	Identifier ID	ID Type	Issuer
TN	01071796	Other	AMERIGROUP COMMUNITY CARE
TN	3044	Other	CARECENTRIX
	S073099	Other	IHP
TN	128747	Other	FIRST HEALTH
TN	1452422	Medicaid
	1987144	Other	COVENTRY HEALTHCARE
	233009	Other	ANTHEM
TN	3123555	Other	BLUECROSS BLUESHIELD TN
KY	90274275	Medicaid
TN	1045278	Other	STERLING LIFE INSURANCE
KY	2444181000	Other	PASSPORT ADVANTAGE
TN	123150	Other	UNISON ADVANTAGE
KY	50002684	Other	PASSPORT HEALTH
MO	626170203	Medicaid
TN	01071796	Other	AMERIGROUP COMMUNITY CARE
OK	200007930A	Medicaid
IN	200279690A	Medicaid
KY	50002684	Other	PASSPORT HEALTH
AZ	885882	Medicaid
KY	90274275	Medicaid
WA	9055963	Medicaid
VA	010066930	Medicaid
TX	154723401	Medicaid
NM	51281775	Medicaid
PA	101210014 0001	Medicaid
TN	1452422	Medicaid
AR	148632716	Medicaid
	1987144	Other	COVENTRY HEALTHCARE
KY	2444181000	Other	PASSPORT ADVANTAGE
UT	321748411007	Medicaid
TN	=========A	Other	WELLCARE
	S073099	Other	IHP
MS	04284502	Medicaid
OK	200007930A	Medicaid
GA	827488729A	Medicaid
WA	9055963	Medicaid
TN	128747	Other	FIRST HEALTH
	=========	Other	TODAY'S OPTION'S
TN	=========TN	Other	ORCHID MEDICAL INSURANCE
CT	00312896	Medicaid
PA	101210014 0001	Medicaid