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NPI Code Detail

MEDICARE: PUBLIX SUPER MARKETS, INC.

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 License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy
33336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1073086781
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 :
Fax Number :
Provider Business Practice Location Address
First Line : 4771 W ATLANTIC AVE
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33445-3838
Country : US
Telephone Number : 561-808-1254
Fax Number : 561-404-8002
Authorized Official
Title or Position : VP PHARMACY
Name : DAIN RUSK
Credential :
Telephone Number : 863-688-1188
Provider Enumeration Date : 01/04/2019
Last Update Date : 12/03/2019

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Directions to “PUBLIX SUPER MARKETS, INC. ” Practice Location

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