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
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	PH26979	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2141338	OTHER	PK

General Provider Information

NPI Number	:	1356783823
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	:	2438 LAUREL RD E
Second Line	:
City	:	NORTH VENICE
State	:	FL
Zip	:	34275-3204
Country	:	US
Telephone Number	:	941-488-2459
Fax Number	:	941-234-0986

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

Provider Enumeration Date	:	07/24/2013
Last Update Date	:	11/15/2019

Similar Medicare Providers

1548254204 — DR. CATHERINE A. FEDAKO MD
Practice Location Address:

2446 LAUREL RD E
NORTH VENICE, FL
34275-3204

Practice Phone: 941-218-6200
Practice Fax: 941-218-6182

1285042739 — PUBLIX PHARMACY #1433
Practice Location Address:

2438 LAUREL RD E
NORTH VENICE, FL
34275-3204

Practice Phone: 941-488-2459
Practice Fax:

1922403591 — PETE SENCHYSHAK RPH
Practice Location Address:

2438 LAUREL RD E
NORTH VENICE, FL
34275-3204

Practice Phone: 941-488-2459
Practice Fax: 941-234-0986

1518535137 — GULF COAST HMA PHYSICIAN MANAGEMENT LLC
Practice Location Address:

2446 LAUREL RD E
NORTH VENICE, FL
34275-3204

Practice Phone: 941-218-6200
Practice Fax: 941-218-6182

1497530489 — JARRETT BROWN PHARMD
Practice Location Address:

2438 LAUREL RD E
NORTH VENICE, FL
34275-3204

Practice Phone: 941-484-8426
Practice Fax:

1457069213 — WELLNESS U, LLC
Practice Location Address:

2462 LAUREL RD E UNIT 544
NOKOMIS, FL
34275-3204

Practice Phone: 423-240-8288
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.