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NPI Code Detail

MEDICARE: PUBLIX SUPER MARKETS INC

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
13336C0003XCommunity/Retail Pharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
3333600000XPharmacyPH24416FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12123605OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891026399
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 : 120 MARKETSIDE AVE
Second Line :
City : PONTE VEDRA
State : FL
Zip : 32081-0574
Country : US
Telephone Number : 904-825-1913
Fax Number : 904-825-6768
Authorized Official
Title or Position : VP OF PHARMACY
Name : CATHERINE E SCANLON
Credential :
Telephone Number : 863-688-1188
Provider Enumeration Date : 01/22/2010
Last Update Date : 06/17/2026

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