Organization
PUBLIX SUPER MARKETS INC
Active
Other names
Publix Pharmacy #0143
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE SCANLON (MANAGER OF MANAGED CARE)
(863) 688-1188
Entity
Organization
Contact information
Practice address
1910 LAKE WORTH RD, LAKE WORTH, FL 33461-4228
(561) 533-6885
(561) 585-0185
Mailing address
PO BOX 116181, ATLANTA, GA 30368-6181
(863) 688-1188
(863) 616-5846
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH0014308
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105410400
—
FL
01
—
2010300
PK
—
Enumeration date
06/08/2006
Last updated
03/21/2014
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