Publix Pharmacy #1105

LBN: Publix Super Markets Inc
Publix Pharmacy #1105 is an health care organization with primary practice located at 13820 Old Saint Augustine Rd , Jacksonville FL 32258-5427. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Publix Super Markets Inc can be contacted via phone (904) 262-5446, or through Rusk, Dain via phone (863) 688-1188.

Contact Information

Primary practice address
13820 Old Saint Augustine Rd Jacksonville FL 32258-5427
Phone: (904) 262-5446
Fax: (904) 262-5488
Website:
Map and Directions
Authorized official contact:
Name: Rusk, Dain
Phone: (863) 688-1188

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PH0020880 Florida

Profile Details

NPI number 1184663072
LBN Legal business name Publix Super Markets Inc
DBA Doing business as Publix Pharmacy #1105
Authorized official Rusk, Dain
Entity Organization
Organization subpart 1 No
Enumeration date Jun 6th, 2006
Last updated Dec 6th, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184663072 NPPES
Florida MEDICAID 028184101
Florida MEDICAID 028184100
Florida Other 2009141

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