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General NPI Number Information
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NPI Number | 1609680461
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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 | 02/03/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 1700 N BLVD
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City | TAMPA
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State | FL
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Zip | 33607
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Country | US
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Telephone | 813-462-4244
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Fax | 813-305-7022
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Provider Business Mailing Address
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Address Line | PO BOX 407
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City | LAKELAND
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State | FL
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Zip | 33802-0407
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Country | US
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Telephone | 863-688-1188
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Fax | 863-616-5810
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Authorized Official
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Title or Position | VP OF PHARMACY
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Name | DAIN RUSK
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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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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