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

General Provider Information

NPI Number	:	1982237400
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	:

Provider Business Practice Location Address
First Line	:	5829 CAMPBELLTON ROAD, S.W
Second Line	:	SUITE 110
City	:	ATLANTA
State	:	GA
Zip	:	30331
Country	:	US
Telephone Number	:	404-469-0542
Fax Number	:	404-239-2511

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

Provider Enumeration Date	:	02/13/2020
Last Update Date	:	09/23/2020

Similar Medicare Providers

1316874399 — GABRIELLE SMITH
Practice Location Address:

6344 ROSETTA DR SW
ATLANTA, GA
30331-8226

Practice Phone: 804-627-1597
Practice Fax:

1326263518 — GEORGIA UROLOGY PA
Practice Location Address:

3890 REDWINE RD SW , SUITE 112
ATLANTA, GA
30331-5582

Practice Phone: 404-766-7151
Practice Fax: 404-761-5419

1467389023 — ANGEL BARNES
Practice Location Address:

2440 FAIRBURN RD SW STE 101
ATLANTA, GA
30331-5253

Practice Phone: 470-419-8442
Practice Fax: 470-419-8402

1568468403 — TAJ EUBANKS M.D.
Practice Location Address:

5835 CAMPBELLTON RD SW STE 204
ATLANTA, GA
30331-8014

Practice Phone: 404-376-3639
Practice Fax: 404-393-7828

1609873934 — DR. IYABODE F AKINSANYA-BEYSOLOW M.D.,M.P.H.
Practice Location Address:

3915 CASCADE RD SW , PROMENADE PARK BUILDING,SUITE 310
ATLANTA, GA
30331-8512

Practice Phone: 404-699-1339
Practice Fax: 404-699-1380

1558368845 — DR. MARIA G. AXELROD MD
Practice Location Address:

910 DANNON VW SW STE 2102
ATLANTA, GA
30331-2156

Practice Phone: 404-691-6100
Practice Fax: 404-691-6959

1538167119 — TAWIAN MCKENNON LIVINGSTON MD
Practice Location Address:

3885 PRINCETON LAKES WAY SW STE 300
ATLANTA, GA
30331-5590

Practice Phone: 404-344-0059
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.