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Organization

PUBLIX SUPER MARKETS INC

Active
Other names
Publix Pharmacy #1270
Organization subpart
No

Provider details

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

Contact information

Practice address
2515 S FLORIDA AVE, LAKELAND, FL 33803-3858
(863) 686-4241
(863) 687-0049
Mailing address
PO BOX 639680, CINCINNATI, OH 45263-9680
(863) 688-1188
(863) 616-5846

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
PH0010352
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
109961200
FL
01
2008978
PK
Enumeration date
07/14/2006
Last updated
12/06/2019
About Stedi
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  • EDI platform