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Contact Information

PUBLIX SUPER MARKETS INC
15 LAUREL CANYON VILLAGE CIR., SUITE 118
CANTON, GA30114
 Phone: 770-479-3711
 Fax: 770-882-0163
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PUBLIX SUPER MARKETS INC

NPI Number 1477886315
LBN Legal business name PUBLIX SUPER MARKETS INC
Authorized official DAIN RUSK - (VP PHARMACY)
Entity Organization
Organization subpart 1 No
Enumeration date 09/10/2009
Last updated 10/27/2022 - About 4 years ago
Identifiers
GA License # PHRE009600
GA Medicaid 862849293A
Other 2121903 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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