Organization
PUBLIX SUPER MARKETS INC
Active
Other names
Publix Pharmacy #1413
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
902 CURLEW RD, DUNEDIN, FL 34698-1901
(727) 736-9208
(727) 483-5471
Mailing address
PO BOX 639680, CINCINNATI, OH 45263-9680
(863) 688-1188
(863) 616-5846
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH26371
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006779000
—
FL
05
—
006779001
—
FL
01
—
2137102
PK
—
Enumeration date
09/25/2012
Last updated
12/03/2019
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