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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
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacyPH31112FL
33336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12174800OTHERPK

General Provider Information

NPI Number : 1902318231
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 :
Provider Business Practice Location Address
First Line : 1430 TIGER PARK LN
Second Line :
City : GULF BREEZE
State : FL
Zip : 32563-5718
Country : US
Telephone Number : 850-203-6469
Fax Number : 850-677-3588
Authorized Official
Title or Position : VP OF PHARMACY
Name : CATHERINE E SCANLON
Credential :
Telephone Number : 863-688-1188
Provider Enumeration Date : 10/26/2017
Last Update Date : 06/18/2026

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Directions to “PUBLIX SUPER MARKETS INC ” Practice Location

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