Organization
PUBLIX SUPER MARKETS INC
Active
Other names
Publix Pharmacy #1064
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
120 PROMINENCE POINT PKWY, CANTON, GA 30114-9008
(770) 720-4825
(770) 882-0162
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
PHRE008797
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015539
PK
—
05
—
444039876A
—
GA
Enumeration date
06/05/2006
Last updated
10/27/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us