Organization
PUBLIX SUPER MARKETS INC
Active
Other names
Publix Pharmacy #1467
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
9951 W FLAGLER ST, MIAMI, FL 33174-1805
(305) 207-2334
(786) 577-4199
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
PH28713
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014124300
—
FL
05
—
014124301
—
FL
01
—
2148926
PK
—
Enumeration date
11/17/2014
Last updated
03/07/2024
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