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Organization

PUBLIX SUPER MARKETS INC

Active
Other names
Publix Pharmacy #1458
Organization subpart
No

Provider details

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

Contact information

Practice address
4860 DAVIS BLVD, NAPLES, FL 34104-5337
(239) 732-7318
(239) 330-6045
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
3336C0003X
Community/Retail Pharmacy
Primary
PH27538
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
011034500
FL
05
011034501
FL
01
2144687
PK
Enumeration date
03/12/2014
Last updated
12/03/2019
About Stedi
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