Provider Type Icon

PUBLIX ALABAMA LLC NPI 1790297000


NPI Information

NPI: 1790297000
Provider Name: PUBLIX ALABAMA LLC

Other Name: PUBLIX PHARMACY #1604

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 01D2141412

Address:
100 N FLORIDA ST
MOBILE, AL
ZIP 36607
Phone: (251) 509-0394
Get Directions

PUBLIX ALABAMA LLC is a community/retail pharmacy pharmacy in Mobile, AL. 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 ALABAMA LLC NPI is 1790297000. The provider is registered as an organization entity type.
The provider Other Name Is Publix Pharmacy #1604.

The provider's business location address is:

100 N FLORIDA ST
MOBILE, AL
ZIP 36607-010
Phone: (251) 509-0394
Fax: (251) 264-3480

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 01D2141412 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/26/2017 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
2333600000XPharmacy114779ALABAMANo
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
12174814OTHERPK
2212491MEDICAIDALABAMA

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

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.