PUBLIX SUPER MARKETS INC NPI 1164461000

NPI Information

  • NPI: 1164461000
  • Provider Name: PUBLIX SUPER MARKETS INC
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Doing Business As: PUBLIX PHARMACY #1287
  • Address: 17179 TAMIAMI TRL
    NORTH PORT, FL
    ZIP 34287
  • Phone: (941) 426-8577

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NPI Details

PUBLIX SUPER MARKETS INC is a pharmacy in North Port, FL. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. PUBLIX SUPER MARKETS INC NPI is 1164461000. The provider is registered as an organization entity type.
The provider Is Doing Business As Publix Pharmacy #1287.

The provider's business location address is:

17179 TAMIAMI TRL
NORTH PORT, FL
ZIP 34287-291
Phone: (941) 426-8577
Fax: (941) 423-8656

The provider's authorized official is Dain Rusk .
The authorized official title is Vp Pharmacy and has the following contact phone number (863) 688-1188.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count (HCPCS:K1034)
  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
  • Fee covid-19 vac 14 res (HCPCS:0134A)
  • Adm sarscv2 30mcg trs-sucr b (HCPCS:0054A)
  • Fee covid-19 vac 13 res (HCPCS:0124A)
  • Administration of pneumococcal vaccine (HCPCS:G0009)
  • Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free (HCPCS:90674)
  • Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)

The enumeration date for this NPI number is 6/6/2006 and was last updated on 12/6/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyPH0011799FLORIDAYes
23336C0003XPharmacyCommunity/Retail PharmacyNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12011071OTHERPK
2101262200MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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