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Organization

PUBLIX SUPER MARKETS INC

Active
Other names
Publix Pharmacy #1285
Organization subpart
No

Provider details

NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization

Contact information

Practice address
1455 SR 436, UNIT 221, CASSELBERRY, FL 32707
(407) 673-0788
(407) 673-0987
Mailing address
PO BOX 639680, CINCINNATI, OH 45263-9680
(863) 688-1188
(863) 616-5846

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
Primary
PH24561
FL
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002355100
FL
01
2124618
PK
Enumeration date
04/12/2010
Last updated
12/06/2019
About Stedi
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