Look up the most recent NPI and PECOS records

Publix Super Markets Inc

(Publix Pharmacy #0891)

Pharmacy

Suppliers

30535 Us Highway 19 N, Palm Harbor, FL 34684-4415

PECOS Enrollment

Based on the most recent information from CMS, provider Publix Super Markets Inc does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 11:51 AM.

Profile Details

Provider ID
1013957422
Provider Type
Organization
Full Name
Publix Super Markets Inc
Other Name
Publix Pharmacy #0891

Subpart
No
Enumeration Date
6/7/2006
Last Updated
12/6/2019

Contact Information

Practice Location

30535 Us Highway 19 N, Palm Harbor, FL 34684-4415

(727) 787-8869

(727) 786-7062

Mailing Location

PO Box 639680, Cincinnati, OH 45263-9680

(863) 688-1188

(863) 616-5846

Authorized Official

Rusk, Dain (Vp Pharmacy)

(863) 688-1188

Provider Taxonomies

Code	Description	License
Code 3336C0003X Primary	Description Pharmacy Suppliers	License PH0019409 Florida
Code 332B00000X	Description Durable Medical Equipment & Medical Supplies Suppliers	License Unlisted Issuer
Code 333600000X	Description Pharmacy Suppliers	License Unlisted Issuer

Provider Identifiers

ID	Description	Issuer
ID 026279000	Description Medicaid	Issuer Unlisted Florida
ID 2015758	Description Other	Issuer PK

Publix Super Markets Inc

(Publix Pharmacy #0891)

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

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Description

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License

Code

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License

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License

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