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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PH27366	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2143941	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366864894
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	:	13178 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2406
Country	:	US
Telephone Number	:	813-961-2658
Fax Number	:	813-639-8981

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

Provider Enumeration Date	:	01/17/2014
Last Update Date	:	12/03/2019

Similar Medicare Providers

1285591719 — TATJANA JAKOVLEV
Practice Location Address:

13172 N DALE MABRY HWY
TAMPA, FL
33618-2406

Practice Phone: 813-374-8981
Practice Fax:

1912914995 — WALGREEN CO
Practice Location Address:

13130 N DALE MABRY HWY
TAMPA, FL
33618-2406

Practice Phone: 813-962-4983
Practice Fax: 813-265-4406

1467749119 — DR. QILIN LU M.D
Practice Location Address:

13172 N DALE MABRY HWY
TAMPA, FL
33618-2406

Practice Phone: 813-374-8981
Practice Fax: 813-521-7422

1376823856 — MR. SANDRA EILEEN ANDERSON RPH
Practice Location Address:

13130 N DALE MABRY HWY
TAMPA, FL
33618-2406

Practice Phone: 813-962-4983
Practice Fax: 813-265-4406

1508135039 — MYHANH THI TRAN PHARMD
Practice Location Address:

13130 N DALE MABRY HWY
TAMPA, FL
33618-2406

Practice Phone: 813-885-1539
Practice Fax: 813-265-4406

1740529882 — AMY LEIGH SAILORS PHARMD
Practice Location Address:

13130 N DALE MABRY HWY
TAMPA, FL
33618-2406

Practice Phone: 813-962-4983
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.