Organization
PUBLIX SUPER MARKETS INC
Active
Other names
Publix Pharmacy #0451
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
3620 ATLANTA HWY, ATHENS, GA 30606-7219
(706) 208-3706
(706) 316-1244
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
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE007664
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00574087A
—
GA
01
—
2018657
PK
—
Enumeration date
06/05/2006
Last updated
11/18/2019
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