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
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1518577576
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	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7340 KATHLEEN RD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33810-4495
Country	:	US
Telephone Number	:	863-797-1001
Fax Number	:	863-226-6481

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

Provider Enumeration Date	:	08/05/2020
Last Update Date	:	11/17/2020

Similar Medicare Providers

1023254950 — DENISE ANN CUMMINGS FAGAN LMHC
Practice Location Address:

7364 KATHLEEN RD # 1021
LAKELAND, FL
33810-4495

Practice Phone: 813-768-3557
Practice Fax:

1508522095 — AUDE SCAFFA LAGUERRE PHARMD
Practice Location Address:

7340 KATHLEEN RD
LAKELAND, FL
33810-4495

Practice Phone: 863-797-1000
Practice Fax:

1245168004 — MARIA JOSE MORALES VACA
Practice Location Address:

3409 NARROWS DR
LAKELAND, FL
33810-1610

Practice Phone: 321-961-6938
Practice Fax:

1992642219 — ASHLEY NICOLE PAYNE RN
Practice Location Address:

4208 OLLIE RD
LAKELAND, FL
33810-0122

Practice Phone: 863-666-7555
Practice Fax:

1104785112 — EAGLE PHARMACY LLC
Practice Location Address:

330 EAGLES LANDING DR STE 250
LAKELAND, FL
33810-3041

Practice Phone: 833-819-0923
Practice Fax:

1487581716 — EAGLE PHARMACY LLC
Practice Location Address:

330 EAGLES LANDING DR STE 260
LAKELAND, FL
33810-3041

Practice Phone: 202-930-4242
Practice Fax: 202-930-4243

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.