Organization
PUBLIX SUPER MARKETS, INC.
Active
Other names
Publix Pharmacy #2113
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP OF PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
1975 SILVERLEAF PKWY STE 101, SAINT AUGUSTINE, FL 32092-2059
(904) 815-6987
(904) 341-1209
Mailing address
PO BOX 407, LAKELAND, FL 33802-0407
(863) 688-1188
(863) 616-5810
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
09/29/2025
Last updated
01/23/2026
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