Organization
PUBLIX TENNESSEE LLC
Active
Other names
Publix Pharmacy #1426
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
2324 LEBANON PIKE, NASHVILLE, TN 37214-2411
(615) 884-2771
(615) 970-7683
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
5140
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139032
PK
—
Enumeration date
02/12/2013
Last updated
01/03/2020
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