Organization
PUBLIX SUPER MARKETS, INC.
Active
Other names
Publix Pharmacy #1775
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP, PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
2830 HIGHWAY 52, MONCKS CORNER, SC 29461
(843) 809-6083
(706) 907-0059
Mailing address
PO BOX 639680, CINCINNATI, OH 45263-9680
(863) 688-1188
(863) 616-5810
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
04/15/2022
Last updated
10/01/2024
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