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Organization

PUBLIX SUPER MARKETS, INC.

Active
Other names
Publix Pharmacy #1806
Organization subpart
No

Provider details

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

Contact information

Practice address
955 WOOD DUCK DR, MYRTLE BEACH, SC 29577-9412
(843) 691-6041
(843) 492-6276
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
07/05/2022
Last updated
09/26/2022
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