OrganizationPublix Super Markets Inc(Publix Pharmacy #0415)PharmacySuppliersPractice Address33343 Us Highway 19 N, Palm Harbor, FL 34684-3128(727) 789-2879(863) 688-1188PECOS EnrollmentBased on the most recent information from CMS, provider Publix Super Markets Inc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1073552915Provider TypeOrganizationFull NamePublix Super Markets IncOther NamePublix Pharmacy #0415SubpartNoEnumeration Date6/6/2006Last Updated8/13/2020Contact InformationPractice LocationPractice Address33343 Us Highway 19 N, Palm Harbor, FL 34684-3128Phone(727) 789-2879Fax(727) 787-4580Mailing LocationMailing AddressPO Box 639680, Cincinnati, OH 45263-9680Phone(863) 688-1188Fax(863) 616-5846Authorized OfficialNameRusk, Dain (Vp Pharmacy)Phone(863) 688-1188Provider TaxonomiesCodeDescriptionLicenseCode3336C0003XPrimaryDescriptionPharmacySuppliersLicensePH0011818FloridaCode332B00000XDescriptionDurable Medical Equipment & Medical SuppliesSuppliersLicenseUnlisted IssuerCode333600000XDescriptionPharmacySuppliersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID2011077DescriptionOtherIssuerPKID101346701DescriptionMedicaidIssuerUnlistedFloridaID101346700DescriptionMedicaidIssuerUnlistedFlorida