Organization
PUBLIX SUPER MARKETS INC
Active
Other names
Publix Pharmacy #1071
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
2880 GEORGIA HIGHWAY 212 SW, CONYERS, GA 30094-3349
(770) 388-0320
(770) 388-7383
Mailing address
PO BOX 639680, CINCINNATI, OH 45263-9680
(863) 688-1188
(863) 616-5846
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE008799
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114961477A
—
GA
01
—
2015538
PK
—
Enumeration date
06/05/2006
Last updated
11/20/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us