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General NPI Number Information
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NPI Number | 1083653042
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Entity Type | Organization
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Legal Business Name | PUBLIX SUPER MARKETS INC
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 12/06/2007
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Provider Practice Location Address
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Address Line | 20321 SUMMERLIN RD
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City | FT MYERS
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State | FL
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Zip | 33908-3706
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Country | US
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Telephone | 239-454-1704
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Fax | 239-454-3319
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Provider Business Mailing Address
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Address Line | 20321 SUMMERLIN RD
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City | FT MYERS
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State | FL
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Zip | 33908-3706
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CONTRACT ADMINISTRATOR
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Name | SARAH POPE
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Credential |
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Telephone | 863-688-1188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PH0019172
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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