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	PH0018175	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	2014150	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	:	1346289212
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	:	5655 RED BUG LAKE RD
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-5013
Country	:	US
Telephone Number	:	407-695-5814
Fax Number	:	407-695-7492

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	01/03/2020

Similar Medicare Providers

1639275126 — DR. CHRISTOPHER S YOUNG D.M.D.
Practice Location Address:

5659 RED BUG LAKE RD
WINTER SPRINGS, FL
32708-5013

Practice Phone: 407-696-6700
Practice Fax: 407-696-6633

1356689673 — MRS. FANNIE A. INGRAM RPH
Practice Location Address:

5655 RED BUG LAKE RD
WINTER SPRINGS, FL
32708-5013

Practice Phone: 407-695-5814
Practice Fax:

1205574555 — LUXOTTICA OF AMERICA INC
Practice Location Address:

5641 RED BUG LAKE RD UNIT 1B
WINTER SPRINGS, FL
32708-5013

Practice Phone: 407-961-5678
Practice Fax: 855-881-9434

1851276877 — DR. KEIAN HALLS
Practice Location Address:

5655 RED BUG LAKE RD
WINTER SPRINGS, FL
32708-5013

Practice Phone: 407-695-5814
Practice Fax:

1841606548 — COMPREHENSIVE FAMILY MEDICINE, LLC
Practice Location Address:

1016 BRAEMAR DR
WINTER PARK, FL
32792-5013

Practice Phone: 205-746-0070
Practice Fax:

1225264682 — NAPLES HMA, LLC
Practice Location Address:

24231 WALDEN CENTER DR , SUITE 202
BONITA SPRINGS, FL
34134-5013

Practice Phone: 239-348-4000
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.