PUBLIX SUPER MARKETS INC NPI 1659311512

NPI Information

  • NPI: 1659311512
  • Provider Name: PUBLIX SUPER MARKETS INC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Doing Business As: PUBLIX PHARMACY #1118
  • Address: 1591 GEORGIA HIGHWAY 20 NE
    CONYERS, GA
    ZIP 30012
  • Phone: (678) 413-2471

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NPI Details

PUBLIX SUPER MARKETS INC is a community/retail pharmacy pharmacy in Conyers, GA. The provider is 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. PUBLIX SUPER MARKETS INC NPI is 1659311512. The provider is registered as an organization entity type.
The provider Is Doing Business As Publix Pharmacy #1118.

The provider's business location address is:

1591 GEORGIA HIGHWAY 20 NE
CONYERS, GA
ZIP 30012-834
Phone: (678) 413-2471
Fax: (678) 413-2476

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.

  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
  • Fee covid-19 vac 14 res (HCPCS:0134A)
  • Fee covid-19 vac 13 res (HCPCS:0124A)
  • Adm sarscv2 30mcg trs-sucr b (HCPCS:0054A)

The enumeration date for this NPI number is 6/8/2006 and was last updated on 11/20/2019.

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
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacyNo
33336C0003XPharmacyCommunity/Retail PharmacyPHRE008988GEORGIAYes

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
12016142OTHERPK
2851444153AMEDICAIDGEORGIA

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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