Publix Pharmacy #0863

LBN: Publix Super Markets Inc
Publix Pharmacy #0863 is an health care organization with primary practice located at 1030 Old Peachtree Rd Nw , Lawrenceville GA 30043-3308. 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 / Community/Retail Pharmacy is the primary health care specialty. Publix Super Markets Inc can be contacted via phone (678) 442-0831, or through Rusk, Dain via phone (863) 688-1188.

Contact Information

Primary practice address
1030 Old Peachtree Rd Nw Lawrenceville GA 30043-3308
Fax: (678) 442-6707
Website:
Authorized official contact:
Name: Rusk, Dain

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHRE008683 Georgia

Profile Details

NPI number 1912947466
LBN Legal business name Publix Super Markets Inc
DBA Doing business as Publix Pharmacy #0863
Authorized official Rusk, Dain
Entity Organization
Organization subpart 1 No
Enumeration date Jun 6th, 2006
Last updated Jun 19th, 2020 - about 4 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 1912947466 NPPES
Other 2014698 PK
MEDICAID 112040674A PK

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