Organization
PUBLIX SUPER MARKETS INC
Active
Other names
Publix Pharmacy #0144
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
40932 US HIGHWAY 19 N, TARPON SPRINGS, FL 34689-5446
(727) 938-3760
(727) 943-8958
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
PH24606
FL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002354600
—
FL
05
—
002354601
—
FL
01
—
2124666
PK
—
Enumeration date
04/12/2010
Last updated
02/01/2022
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