Provider Information for 1871895581
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PUBLIX SUPER MARKETS INC
Other Names:Doing Business As:PUBLIX PHARMACY #1291Organization Subpart: NO
NPI: 1871895581
Last Updated: 2022-10-27
Certification Date: 2022-10-27
Certification Date: 2022-10-27
Details
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NPI | 1871895581 | ||||||||||||||||
Enumeration Date | 2010-12-01 | ||||||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||||||
Status | Active | ||||||||||||||||
Authorized Official Information | Name: DAIN RUSK Title: VP Pharmacy Phone: 8636881188 | ||||||||||||||||
Mailing Address | PO BOX 639680 CINCINNATI, OH 45263-9680 United States Phone: 863-688-1188 | Fax:863-616-5846 | ||||||||||||||||
Primary Practice Address | 6015 WATSON BLVD BYRON, GA 31008-6650 United States Phone: 478-953-2615 | Fax:478-845-2771 | ||||||||||||||||
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