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Organization

PUBLIX SUPER MARKETS, INC.

Active
Other names
Publix Pharmacy #1561
Organization subpart
No

Provider details

NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization

Contact information

Practice address
1420 NW NORTH RIVER DR STE 110, MIAMI, FL 33125-2889
(786) 988-6447
(786) 522-1132
Mailing address
PO BOX 407, LAKELAND, FL 33802-0407

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary

Other

Enumeration date
11/01/2019
Last updated
09/15/2020
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