PUBLIX ALABAMA LLC NPI 1790297000

NPI Information

  • NPI: 1790297000
  • Provider Name: PUBLIX ALABAMA LLC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Other Name: PUBLIX PHARMACY #1604
  • CLIA Number: 01D2141412
  • Address: 100 N FLORIDA ST
    MOBILE, AL
    ZIP 36607
  • Phone: (251) 509-0394

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NPI Details

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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
  • Fee covid-19 vac 14 res (HCPCS:0134A)
  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other 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: 11/21/2025

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