Organization
PUBLIX SUPER MARKETS INC
Active
Other names
Publix Pharmacy #0840
Organization subpart
No
Provider details
NPI number
Authorized official
DAIN RUSK (VP PHARMACY)
(863) 688-1188
Entity
Organization
Contact information
Practice address
10015 N DALE MABRY HWY, TAMPA, FL 33618-4409
(813) 392-4207
(813) 337-6097
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
Primary
PH31328
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2176258
PK
—
Enumeration date
02/22/2018
Last updated
12/06/2019
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