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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
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy
33336C0003XCommunity/Retail PharmacyPH0020836FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22008913OTHERPK

General Provider Information

NPI Number : 1316988801
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 : 863-688-1188
Provider Business Practice Location Address
First Line : 4730 S FLORIDA AVE
Second Line :
City : LAKELAND
State : FL
Zip : 33813-2181
Country : US
Telephone Number : 863-646-5471
Fax Number : 863-701-0950
Authorized Official
Title or Position : VP OF PHARMACY
Name : DAIN RUSK
Credential :
Telephone Number : 863-688-1188
Provider Enumeration Date : 06/08/2006
Last Update Date : 11/17/2025

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Directions to “PUBLIX SUPER MARKETS, INC. ” Practice Location

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