OrganizationPublix Super Markets Inc(Publix Pharmacy #1340)PharmacySuppliersPractice Address35439 U.S. 19 North, Palm Harbor, FL 34684-1737(727) 771-9327(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 3 days ago.Profile DetailsProvider ID1376795732Provider TypeOrganizationFull NamePublix Super Markets IncOther NamePublix Pharmacy #1340SubpartNoEnumeration Date10/16/2008Last Updated12/3/2019Contact InformationPractice LocationPractice Address35439 U.S. 19 North, Palm Harbor, FL 34684-1737Phone(727) 771-9327Fax(727) 784-9143Mailing LocationMailing AddressPO Box 639680, Cincinnati, OH 45263-9680Phone(863) 688-1188Fax(863) 616-5846Authorized OfficialNameRusk, Dain (Vp Pharmacy)Phone(863) 688-1188Provider TaxonomiesCodeDescriptionLicenseCode3336C0003XPrimaryDescriptionPharmacySuppliersLicenseUnlisted IssuerCode332B00000XDescriptionDurable Medical Equipment & Medical SuppliesSuppliersLicenseUnlisted IssuerCode333600000XDescriptionPharmacySuppliersLicensePH23635FloridaProvider IdentifiersIDDescriptionIssuerID2117487DescriptionOtherIssuerPKID000653100DescriptionMedicaidIssuerUnlistedFloridaID000653101DescriptionMedicaidIssuerUnlistedFlorida