Organization
PUBLIX SUPER MARKETS, INC.
Active
Other names
Publix Pharmacy #3215
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
3100 SW 62ND AVE, MIAMI, FL 33155-3009
(305) 669-7155
(786) 348-2515
Mailing address
PO BOX 639680, CINCINNATI, OH 45263-9680
(863) 688-1188
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
PH30015
FL
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017150000
—
FL
05
—
017150001
—
FL
01
—
2158799
PK
—
Enumeration date
03/14/2016
Last updated
02/28/2024
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