PUBLIX SUPER MARKETS INC (NPI# 1083654552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083654552 |
| Entity Type | Organization |
| Organization Name | PUBLIX SUPER MARKETS INC |
| Other Organization Name | PUBLIX PHARMACY #0579 |
| Practice Address |
108 Pavilion Pkwy Fayetteville GA 30214-4056 |
| Mailing Address |
Po Box 639680 Cincinnati OH 45263-9680 |
| Practice Telephone | 7704604106 |
| Practice Fax Number | 7707160674 |
| Mailing Telephone | 8636881188 |
| Mailing Fax Number | 8636165846 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2020-01-03 |
| Authorized Official Name | DAIN RUSK (VP PHARMACY) |
| Authorized Official Telephone | 8636881188 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE008019 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00717967A | 05 | |
| PK | 2019562 | 01 |
| Other Name | Type Code |
|---|---|
| Publix Pharmacy #0579 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548753270 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 18320 Collins Ave, Sunny Isles Beach, FL 33160-2429 | 2018-06-07 |
| 1386147775 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 83268 Overseas Hwy, Islamorada, FL 33036-3511 | 2018-03-13 |
| 1043713746 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 5550 Chamblee Dunwoody Rd, Dunwoody, GA 30338-4111 | 2018-03-09 |
| 1841791126 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 510 Ga Highway 247 S, Bonaire, GA 31005-3865 | 2018-02-22 |
| 1992206254 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 10015 N Dale Mabry Hwy, Tampa, FL 33618-4409 | 2018-02-22 |
| 1609375286 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 4701 S University Dr, Davie, FL 33328-3819 | 2018-02-08 |
| 1689186926 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 10450 Pines Blvd, Pembroke Pines, FL 33026-6044 | 2017-10-26 |
| 1902318231 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 1430 Tiger Park Ln, Gulf Breeze, FL 32563-5718 | 2017-10-26 |
| 1750892683 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 8455 Nw 53rd Ter, Doral, FL 33166-4517 | 2017-10-18 |
| 1063941052 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 1355 N Ferdon Blvd, Crestview, FL 32536-1713 | 2017-06-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Publix Super Markets Inc. | 15720 Brixham Hill Avenue #300, Charlotte, NC 28277-4651 |
| Street Address |
108 PAVILION PKWY |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-4056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194211425 | Monica Girish Patel | Pharmacist | 108 Pavilion Pkwy, Fayetteville, GA 30214-4056 | 2018-07-10 |
| 1023479334 | Sandra Lai Quach | Pharmacist | 108 Pavilion Pkwy, Fayetteville, GA 30214-4056 | 2016-03-14 |
| 1134469729 | John Mack Barrow | Pharmacist | 108 Pavilion Pkwy, Fayetteville, GA 30214-4056 | 2013-02-19 |
| 1538407952 | Patrick Dewayne Mcclain | Pharmacist | 108 Pavilion Pkwy, Fayetteville, GA 30214-4056 | 2013-01-18 |
| 1316284003 | Gary Martin Kennedy | Pharmacist | 108 Pavilion Pkwy, Fayetteville, GA 30214-4056 | 2013-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639705957 | Cape Fear Discount Drug - Ramsey, LLC | Pharmacy | 4417 Ramsey St, Fayetteville, NC 28311-2134 | 2020-03-18 |
| 1003391491 | Platinum Pharmacy | Pharmacy | 935 Lanier Ave W Ste 1008, Fayetteville, GA 30214-7434 | 2018-10-01 |
| 1649635459 | Walmart Inc. | Pharmacy | 660 W Martin Luther King Blvd, Fayetteville, AR 72701-6443 | 2015-12-21 |
| 1003203878 | R & R Medical Inc | Pharmacy | 2127 N Center St, Suite 1, Fayetteville, AR 72701-9449 | 2015-04-20 |
| 1598171910 | Express Discount Pharmacy LLC | Pharmacy | 1905 Skibo Rd Ste 104, Fayetteville, NC 28314-0261 | 2014-07-07 |
| 1760803035 | Walgreen Co | Pharmacy | 4015 W Wedington Dr, Fayetteville, AR 72704-5733 | 2014-01-03 |
| 1740535715 | Harris Teeter, LLC | Pharmacy | 3050 Traemoor Village Dr, Fayetteville, NC 28306 | 2012-07-17 |
| 1093013591 | Nugen Pharmacy LLC | Pharmacy | 101 Yorktown Dr Ste 102, Fayetteville, GA 30214-1568 | 2011-03-08 |
| 1477880185 | Carlie Cs of Cliffdale LLC | Pharmacy | 690 S Reilly Rd, Fayetteville, NC 28314-5626 | 2009-11-17 |
| 1922246818 | Calhoun Family Pharmacy Inc | Pharmacy | 4417 Ramsey Street, Fayetteville, NC 28311 | 2009-01-30 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
Please comment or provide details below to improve the information on PUBLIX SUPER MARKETS INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.