Organization
PUBLIX SUPER MARKETS INC
Active
Other names
Publix Pharmacy #1434
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
1981 TAMIAMI TRL N, NAPLES, FL 34102-4804
(239) 262-0273
(239) 963-2464
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
PH26465
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007389500
—
FL
05
—
007389501
—
FL
01
—
2137919
PK
—
Enumeration date
11/19/2012
Last updated
12/03/2019
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