# PUBLIX SUPER MARKETS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Publix Pharmacy \#0545
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225078645
- **Authorized official:** JACQUELINE RUSCH (MANAGER OF MANAGED CARE)
- **Authorized official phone:** (863) 688-1188

## Contact information

- **Practice address:** 11155 TARA BLVD, HAMPTON, GA 30228-1672
- **Practice address phone:** (770) 473-6886
- **Practice address fax:** (770) 473-4716
- **Mailing address:** PO BOX 116181, ATLANTA, GA 30368-6181
- **Mailing address phone:** (863) 688-1188
- **Mailing address fax:** (863) 616-5846

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHRE007931 | GA | Yes |

## Other

- **Enumeration date:** 06/07/2006
- **Last updated:** 08/04/2015