Organization
PUBLIX SUPER MARKETS, INC.
Active
Other names
Publix Pharmacy #1842
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP, PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
11025 ETOWN PKWY SUITE 101, JACKSONVILLE, FL 32256
(904) 944-8972
(907) 406-7184
Mailing address
PO BOX 639680, CINCINNATI, OH 45263-9680
(863) 688-1188
(863) 616-5810
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
11/29/2022
Last updated
05/03/2023
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