Organization
PUBLIX SUPER MARKETS, INC
Active
Other names
Publix Pharmacy #1807
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
5854 DOGWOOD DR, MILTON, FL 32570-3576
(850) 564-2670
(850) 502-8872
Mailing address
PO BOX 639680, CINCINNATI, OH 45263-9680
(863) 688-1188
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
10/19/2021
Last updated
08/23/2022
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