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	PH0018743	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	2014975	OTHER	PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275572232
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	:	9850 LITTLE RD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34654-3470
Country	:	US
Telephone Number	:	727-869-7919
Fax Number	:	727-863-6079

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

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	01/31/2022

Similar Medicare Providers

1033103999 — DR. MICHAEL J CAUSEY O.D.
Practice Location Address:

9832 LITTLE RD
NEW PORT RICHEY, FL
34654-3470

Practice Phone: 727-868-9898
Practice Fax: 727-862-4436

1376749697 — DR. RYAN LE D.D.S.
Practice Location Address:

9836 LITTLE RD
NEW PORT RICHEY, FL
34654-3470

Practice Phone: 919-278-7576
Practice Fax: 919-278-7694

1518167691 — MICHAEL J. CAUSEY
Practice Location Address:

9832 LITTLE RD , SUITE 1
NEW PORT RICHEY, FL
34654-3470

Practice Phone: 727-868-9898
Practice Fax: 727-862-4436

1871830711 — DR. EDUARDO DANIEL OLORTEGUI PHARM D.
Practice Location Address:

9850 LITTLE RD
NEW PORT RICHEY, FL
34654-3470

Practice Phone: 727-869-7919
Practice Fax: 727-863-6079

1033457403 — DR. VANESSA MATOS JUSTINO
Practice Location Address:

9850 LITTLE RD
NEW PORT RICHEY, FL
34654-3470

Practice Phone: 727-869-7919
Practice Fax:

1538715792 — BRITTANY NICOLE GOODWIN PHD
Practice Location Address:

9850 LITTLE RD
NEW PORT RICHEY, FL
34654-3470

Practice Phone: 727-869-7919
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.