Organization
PUBLIX SUPER MARKETS INC
Active
Other names
Publix Pharmacy #1279
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
7334 SPOUT SPRINGS RD, FLOWERY BRANCH, GA 30542-5543
(770) 967-4103
(770) 967-7932
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
PHRE9640
GA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2124904
PK
—
05
—
991871862A
—
GA
Enumeration date
04/29/2010
Last updated
02/26/2026
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