MEDICARE: PUBLIX SUPER MARKETS, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	333600000X	Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1013571314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PUBLIX SUPER MARKETS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 639680
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-9680
Country	:	US
Telephone Number	:	863-688-1188
Fax Number	:	863-616-5846

Provider Business Practice Location Address
First Line	:	730 HOPEWELL DRIVE
Second Line	:
City	:	CHARLESTON-BERKELEY
State	:	SC
Zip	:	29492-7102
Country	:	US
Telephone Number	:	863-688-1188
Fax Number	:	863-616-5846

Authorized Official
Title or Position	:	VP PHARMACY
Name	:	DAIN RUSK
Credential	:
Telephone Number	:	863-688-1188

Provider Enumeration Date	:	04/23/2019
Last Update Date	:	11/18/2019

Similar Medicare Providers

1023627619 — DENTAL PROFESSIONAL OF SOUTH CAROLINA, P.C.
Practice Location Address:

702 HOPEWELL DR
CHARLESTON, SC
29492-7102

Practice Phone: 843-416-9053
Practice Fax: 843-284-8366

1033721543 — PATRICIA LYNN SMITH
Practice Location Address:

323 BERKELEY ST APT B
CHARLESTON, WV
25302-2101

Practice Phone: 304-205-4489
Practice Fax:

1194311936 — CONTESSA K THOMAS
Practice Location Address:

325 BERKELEY ST. APT B
CHARLESTON, WV
25302

Practice Phone: 304-380-5827
Practice Fax:

1396120465 — EAGLE POINT SUPPLIES, LLC
Practice Location Address:

8983 UNIVERSITY BLVD , STE 104 - 103
NORTH CHARLESTON, SC
29406-7102

Practice Phone: 803-305-9120
Practice Fax:

1376901538 — JASMINE LENOCI PA-C
Practice Location Address:

67 PRESIDENT ST
CHARLESTON, SC
29425-7102

Practice Phone: 843-792-9888
Practice Fax:

1811589799 — SARAH GOBLE
Practice Location Address:

5400 BIG TYLER RD APT 7102
CHARLESTON, WV
25313-1138

Practice Phone: 304-928-9796
Practice Fax:

Directions to “PUBLIX SUPER MARKETS, INC. ” 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.