Organization
PUBLIX SUPER MARKETS, INC.
Active
Other names
Publix Pharmacy #1649
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY BONE (MANAGER MANAGED CARE)
(863) 688-1188
Entity
Organization
Contact information
Practice address
1930 STATE ROAD 44, NEW SMYRNA BEACH, FL 32168-8345
(386) 663-6095
(386) 478-4141
Mailing address
PO BOX 116181, ATLANTA, GA 30368-6181
(863) 688-1188
(863) 616-5846
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
02/05/2019
Last updated
05/03/2019
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