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PUBLIX SUPER MARKETS INC NPI 1922444272


NPI Information

NPI: 1922444272
Provider Name: PUBLIX SUPER MARKETS INC

Doing Business As: PUBLIX PHARMACY #0604

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 10D2088386

Address:
24600 S TAMIAMI TRL STE 300
BONITA SPRINGS, FL
ZIP 34134
Phone: (239) 498-6288
Get Directions

PUBLIX SUPER MARKETS INC is a community/retail pharmacy pharmacy in Bonita Springs, FL. 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 SUPER MARKETS INC NPI is 1922444272. The provider is registered as an organization entity type.
The provider Is Doing Business As Publix Pharmacy #0604.

The provider's business location address is:

24600 S TAMIAMI TRL STE 300
BONITA SPRINGS, FL
ZIP 34134-023
Phone: (239) 498-6288
Fax: (239) 247-5763

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 10D2088386 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/14/2013 and was last updated on 11/15/2019.


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
2333600000XPharmacyNo
33336C0003XPharmacyCommunity/Retail PharmacyPH26817FLORIDAYes

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
12140368OTHERPK
2008335101MEDICAIDFLORIDA
3008835100MEDICAIDFLORIDA

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

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