Organization
PUBLIX SUPER MARKETS INC
Active
Other names
PUBLIX PHARMACY #0513
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH POPE (CONTRACT ADMINISTRATOR)
(863) 688-1188
Entity
Organization
Contact information
Practice address
1660 TAYLOR RD, PORT ORANGE, FL 32128-6753
(386) 756-6175
(386) 756-3985
Mailing address
1660 TAYLOR RD, PORT ORANGE, FL 32128-6753
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PH0013159
FL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1074361
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/07/2006
Last updated
12/06/2007
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