Publix Pharmacy #1243
LBN: Publix Super Markets Inc
Publix Pharmacy #1243 is an health care organization with primary practice located at 120 Marketside Ave , Ponte Vedra FL 32081-0574. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty.
Publix Super Markets Inc can be contacted via phone (904) 825-1913, or through Rusk, Dain via phone (863) 688-1188.
Contact Information
Primary practice address
120 Marketside Ave
Ponte Vedra FL 32081-0574
Phone: (904) 825-1913
Fax: (904) 825-6768
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | PH24416 | Florida |
| Suppliers / Community/Retail Pharmacy | 3336C0003X |
Profile Details
| NPI number | 1891026399 |
|---|---|
| LBN Legal business name | Publix Super Markets Inc |
| DBA Doing business as | Publix Pharmacy #1243 |
| Authorized official | Rusk, Dain |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 22nd, 2010 |
| 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891026399 | NPPES |
| Other | 2123605 | PK | |
| MEDICAID | 001962200 | PK |
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