Organization
PUBLIX SUPER MARKETS INC
Active
Other names
Publix Pharmacy #0054
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
311 SW 7TH ST, MIAMI, FL 33130-2917
(305) 856-9990
(786) 294-6769
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
PH28214
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012743100
—
FL
05
—
012743101
—
FL
01
—
2145800
PK
—
Enumeration date
05/15/2014
Last updated
11/21/2019
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