Organization
PUBLIX SUPER MARKETS INC
Active
Other names
Publix Pharmacy #1455
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
3044 S ATLANTIC AVE, DAYTONA BEACH SHORES, FL 32118-6102
(386) 788-7330
(386) 615-1638
Mailing address
PO BOX 639680, CINCINNATI, OH 45263-9680
(863) 688-1188
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH28678
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014033500
—
FL
05
—
014033501
—
FL
01
—
2148690
PK
—
Enumeration date
10/23/2014
Last updated
10/15/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us