Organization
PUBLIX SUPER MARKETS, INC.
Active
Other names
Publix Pharmacy #1847
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP OF PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
10005 BALLARDSVILLE RD, LOUISVILLE, KY 40241-1202
(502) 302-7926
(502) 212-1469
Mailing address
PO BOX 407, LAKELAND, FL 33802-0407
(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
12/10/2024
Last updated
02/20/2025
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