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	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336C0003X	Community/Retail Pharmacy	PH0019014	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2015315	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609817105
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	:	851 S STATE ROAD 434
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-4811
Country	:	US
Telephone Number	:	407-522-1105
Fax Number	:	407-522-1110

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	11/21/2019

Similar Medicare Providers

1376781237 — KRISTY WOOD DC
Practice Location Address:

851 S STATE ROAD 434 , SUITE 1200
ALTAMONTE SPRINGS, FL
32714-4811

Practice Phone: 407-413-5731
Practice Fax: 407-413-5732

1972840916 — MISS LATCHMI SINGH PHARMD
Practice Location Address:

851 S STATE ROAD 434
ALTAMONTE SPRINGS, FL
32714-4811

Practice Phone: 407-522-1105
Practice Fax:

1396082152 — MICHAEL JOSEPH MURPHY RPH
Practice Location Address:

851 S STATE ROAD 434
ALTAMONTE SPRINGS, FL
32714-4811

Practice Phone: 407-522-1105
Practice Fax: 407-522-1110

1154668721 — DR. KYLE LAMM PHARMD
Practice Location Address:

851 S STATE ROAD 434
ALTAMONTE SPRINGS, FL
32714-4811

Practice Phone: 407-522-1105
Practice Fax:

1144634973 — DISTRICT CHIROPRACTIC & WELLNESS CENTER, INC.
Practice Location Address:

851 S STATE ROAD 434 , SUITE 1200
ALTAMONTE SPRINGS, FL
32714-4811

Practice Phone: 407-413-5731
Practice Fax: 407-413-5732

1780225920 — MR. RAMY MORCOS
Practice Location Address:

851 S STATE ROAD 434
ALTAMONTE SPRINGS, FL
32714-4811

Practice Phone: 407-522-1105
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.