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PUBLIX NORTH CAROLINA LP NPI 1417478322


NPI Information

NPI: 1417478322
Provider Name: PUBLIX NORTH CAROLINA LP

Other Name: PUBLIX PHARMACY #1575

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
3114 RAEFORD RD
FAYETTEVILLE, NC
ZIP 28303
Phone: (910) 364-0133
Get Directions

PUBLIX NORTH CAROLINA LP is a community/retail pharmacy pharmacy in Fayetteville, NC. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. PUBLIX NORTH CAROLINA LP NPI is 1417478322. The provider is registered as an organization entity type.
The provider Other Name Is Publix Pharmacy #1575.

The provider's business location address is:

3114 RAEFORD RD
FAYETTEVILLE, NC
ZIP 28303-378
Phone: (910) 364-0133
Fax: (910) 676-7295

The provider's authorized official is Dain Rusk .
The authorized official title is Vp Pharmacy and has the following contact phone number (863) 688-1188.

The enumeration date for this NPI number is 6/30/2017 and was last updated on 1/3/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacy13358NORTH CAROLINANo
33336C0003XPharmacyCommunity/Retail PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12171895OTHERPK
21417478322MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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