MEDICARE: PUBLIX SUPER MARKETS INC

Medicare Provider Information

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	PH0018622	FL

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2014704	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1437190931
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	:	6767 US HIGHWAY 98 N
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33809-6226
Country	:	US
Telephone Number	:	863-859-5838
Fax Number	:	863-859-6517

Authorized Official
Title or Position	:	VP OF PHARMACY
Name	:	CATHERINE E SCANLON
Credential	:
Telephone Number	:	863-688-1188

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	06/17/2026

6731 US HIGHWAY 98 N
LAKELAND, FL
33809-6226

Practice Phone: 863-850-3043
Practice Fax: 863-853-8135

6767 US HIGHWAY 98 N
LAKELAND, FL
33809-6226