Organization
PUBLIX SUPER MARKETS INC
Active
Other names
Publix Pharmacy 1681
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
949 E BLOOMINGDALE AVE, BRANDON, FL 33511-8118
(813) 413-3150
(813) 443-4443
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
PH30510
FL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019672700
—
FL
05
—
019672701
—
FL
01
—
2166521
PK
—
Enumeration date
11/29/2016
Last updated
06/21/2023
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