Publix Pharmacy #3217

LBN: Publix Super Markets Inc
Publix Pharmacy #3217 is an health care organization with primary practice located at 807 Childrens Way , Jacksonville FL 32207-8426. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Clinic 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) 697-3601, or through Rusk, Dain via phone (863) 688-1188.

Contact Information

Primary practice address
807 Childrens Way Jacksonville FL 32207-8426
Phone: (904) 697-3601
Fax: (904) 697-3053
Website:
Map and Directions
Authorized official contact:
Name: Rusk, Dain
Phone: (863) 688-1188

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X PH30581 Florida
Suppliers / Clinic Pharmacy 3336C0002X
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1639614886
LBN Legal business name Publix Super Markets Inc
DBA Doing business as Publix Pharmacy #3217
Authorized official Rusk, Dain
Entity Organization
Organization subpart 1 No
Enumeration date Dec 27th, 2016
Last updated Feb 1st, 2022 - about 3 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 1639614886 NPPES
Other 2166965 PK
MEDICAID 019907000 PK
MEDICAID 019907001 PK

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