Organization
PUBLIX SUPER MARKETS INC
Active
Other names
Publix Pharmacy #1237
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
1501 NW FEDERAL HWY, STUART, FL 34994-1039
(772) 692-5033
(772) 692-5038
Mailing address
PO BOX 639680, CINCINNATI, OH 45263-9680
(863) 688-1188
(863) 616-5846
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH24289
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001885900
—
FL
01
—
2122621
PK
—
Enumeration date
11/04/2009
Last updated
12/06/2019
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