PUBLIX SUPER MARKETS INC (NPI# 1457390320) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457390320 |
| Entity Type | Organization |
| Organization Name | PUBLIX SUPER MARKETS INC |
| Other Organization Name | PUBLIX PHARMACY #0202 |
| Practice Address |
3200 Lake Washington Rd Melbourne FL 32934-7620 |
| Mailing Address |
Po Box 639680 Cincinnati OH 45263-9680 |
| Practice Telephone | 3212420592 |
| Practice Fax Number | 3212427962 |
| Mailing Telephone | 8636881188 |
| Mailing Fax Number | 8636165846 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2019-11-21 |
| 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 | 333600000X | Pharmacy | Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PH0015909 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 106368501 | 05 | |
| FL | 106368500 | 05 | |
| PK | 2011527 | 01 |
| Other Name | Type Code |
|---|---|
| Publix Pharmacy #0202 | 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 |
3200 LAKE WASHINGTON RD |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32934-7620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760037071 | Stephanie Evanoff | Pharmacist | 3200 Lake Washington Rd, Melbourne, FL 32934-7620 | 2019-08-04 |
| 1033666268 | Kenneth Edward Johnson | Pharmacist | 3200 Lake Washington Rd, Melbourne, FL 32934-7620 | 2016-09-06 |
| 1902248313 | Jeffrey Karn | Pharmacist | 3200 Lake Washington Rd, Melbourne, FL 32934-7620 | 2013-07-26 |
| 1023355609 | James Michael Dale | Pharmacist | 3200 Lake Washington Rd, Melbourne, FL 32934-7620 | 2013-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013530419 | Ryan Thomas Kammerdener | Pharmacist | 3003 Bay Wind Ct, Melbourne, FL 32934 | 2020-05-20 |
| 1558833731 | Deborah J Gaffney | Specialist/Technologist | 3060 Kershaw Court, Melbourne, FL 32934 | 2018-12-27 |
| 1548703200 | Damaris Escarment | Counselor | 3550 W. Eau Gallie Blvd, Melbourne, FL 32934 | 2016-11-29 |
| 1447686324 | Sarai Escarment | Counselor | 3550 W Eau Gallie Blvd, Melbourne, FL 32934 | 2013-09-23 |
| 1871874974 | Felipe E. Dominguez, Md, Pa | Clinical Medical Laboratory | 3030 Venture Lane, Ste 108, Melbourne, FL 32934 | 2011-09-01 |
| 1376821637 | Christine Natasha Williams Kelly | Counselor | 4450 West Eau Gallie Blvd, Suite 200, Melbourne, FL 32934 | 2011-08-03 |
| 1912203316 | Sheryl Yatsko | Physical Therapy Assistant | 3303 Sarno Rd, Melbourne, FL 32934 | 2011-02-01 |
| 1255564191 | Joy Cheryl Mullen | Occupational Therapy Assistant | 1890 Whispering Oaks Cir, West Melbourne, FL 32934 | 2009-08-26 |
| 1619031531 | The Devereux Foundation | Case Management | 1591 Robert J Conlan Boulevard, Palm Bay, FL 32934 | 2006-12-22 |
| 1457456600 | Jo A Kologlu | Physical Therapist | 5025 Smithfield Rd, Melbourne, FL 32934 | 2006-09-13 |
| Find all providers in zip 32934 | ||||
| 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 |
|---|---|---|---|---|
| 1871037333 | Night Owl Pharmacy, Inc. | Pharmacy | 811 E Hibiscus Blvd, Melbourne, FL 32901-3219 | 2016-12-18 |
| 1598115958 | City Discount Pharmacy | Pharmacy | 2330 N Wickham Rd Ste 7, Melbourne, FL 32935-8183 | 2016-06-16 |
| 1265868665 | Wickham Discount Pharmacy LLC | Pharmacy | 1060 N Wickham Rd, Melbourne, FL 32935-8937 | 2013-09-18 |
| 1023112000 | Holiday Cvs LLC | Pharmacy | 1800 N Wickham Rd, Melbourne, FL 32935-8104 | 2006-09-12 |
| 1821192741 | Holiday Cvs LLC | Pharmacy | 19 E New Haven Ave, Melbourne, FL 32901-4403 | 2006-09-12 |
| 1336156314 | Walgreen Co | Pharmacy | 1213 Palm Bay Rd, Melbourne, FL 32905-3781 | 2006-08-02 |
| 1881600351 | Walgreen Co | Pharmacy | 4280 Minton Rd, Melbourne, FL 32904-9564 | 2006-08-01 |
| 1871158113 | University Center Medical LLC | Pharmacy | 1800 W Hibiscus Blvd Ste 101, Melbourne, FL 32901-2624 | 2019-05-02 |
| 1861931198 | Health First Family Pharmacy | Pharmacy | 8725 N Wickham Rd, Suite 102, Melbourne, FL 32940-2239 | 2017-02-20 |
| 1396143475 | Holmes Regional Medical Center, Inc. | Pharmacy | 8725 N Wickham Rd, Melbourne, FL 32940-2239 | 2014-12-05 |
| Find all providers in MELBOURNE | ||||
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| 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.