Organization
PUBLIX SUPER MARKETS INC
Active
Other names
Publix Pharmacy #1345
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
1181 S UNIVERSITY DR, PLANTATION, FL 33324-3322
(954) 577-2637
(954) 577-4048
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
PH24555
FL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002356800
—
FL
01
—
2124810
PK
—
Enumeration date
04/27/2010
Last updated
12/03/2019
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