Organization
PUBLIX SUPER MARKETS, INC.
Active
Other names
Publix Pharmacy #1497
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE RUSCH (MANAGER OF MANAGED CARE)
(863) 688-1188
Entity
Organization
Contact information
Practice address
831 VILLAGE BLVD, WEST PALM BEACH, FL 33409-1901
(863) 688-1188
Mailing address
PO BOX 407, LAKELAND, FL 33802-0407
(863) 688-1188
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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