Organization
PUBLIX SUPER MARKETS, INC.
Active
Other names
Publix Pharmacy #3212
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
2424 ORLANDO CENTRAL PKWY STE 200, ORLANDO, FL 32809-5600
(877) 253-8949
(407) 965-4390
Mailing address
PO BOX 639680, CINCINNATI, OH 45263-9680
(863) 688-1188
(863) 616-5846
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009988000
—
FL
01
—
2142325
PK
—
Enumeration date
09/30/2013
Last updated
07/17/2024
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