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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
1333600000XPharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
33336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1598574006
Entity Type Code : Organization
Provider Name (Legal Business Name) : PUBLIX SUPER MARKETS INC
Provider Business Mailing Address
First Line : PO BOX 407
Second Line :
City : LAKELAND
State : FL
Zip : 33802-0407
Country : US
Telephone Number : 863-688-1188
Fax Number : 863-616-5810
Provider Business Practice Location Address
First Line : 3435 N FEDERAL HWY
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33064-6605
Country : US
Telephone Number : 954-590-4069
Fax Number : 954-773-9659
Authorized Official
Title or Position : VP OF PHARMACY
Name : DAIN RUSK
Credential :
Telephone Number : 863-688-1188
Provider Enumeration Date : 12/31/2024
Last Update Date : 07/02/2025

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Directions to “PUBLIX SUPER MARKETS INC ” Practice Location

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