Organization
PUBLIX SUPER MARKETS INC
Active
Other names
Publix Pharmacy #0212
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
10913 N MILITARY TRL, WEST PALM BEACH, FL 33410-6501
(561) 622-3959
(561) 626-8391
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
PH24478
FL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002060900
—
FL
05
—
002060901
—
FL
01
—
2123998
PK
—
Enumeration date
02/25/2010
Last updated
11/21/2019
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