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PUBLIX SUPER MARKETS INC NPI 1013233402


NPI Information

NPI: 1013233402
Provider Name: PUBLIX SUPER MARKETS INC

Doing Business As: PUBLIX PHARMACY #1285

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 10D2088214

Address:
1455 SR 436, UNIT 221
CASSELBERRY, FL
ZIP 32707
Phone: (407) 673-0788
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PUBLIX SUPER MARKETS INC is a pharmacy in Casselberry, FL. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. PUBLIX SUPER MARKETS INC NPI is 1013233402. The provider is registered as an organization entity type.
The provider Is Doing Business As Publix Pharmacy #1285.

The provider's business location address is:

1455 SR 436, UNIT 221
CASSELBERRY, FL
ZIP 32707
Phone: (407) 673-0788
Fax: (407) 673-0987

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 CLIA number assigned to this NPI record is 10D2088214 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/12/2010 and was last updated on 12/6/2019.


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
2333600000XPharmacyPH24561FLORIDAYes
33336C0003XPharmacyCommunity/Retail PharmacyNo

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
1002355100MEDICAIDFLORIDA
22124618OTHERPK

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.