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PUBLIX SUPER MARKETS INC NPI 1962776286


NPI Information

NPI: 1962776286
Provider Name: PUBLIX SUPER MARKETS INC

Doing Business As: PUBLIX PHARMACY #1406

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 10D2088263

Address:
463855 STATE ROAD 200
YULEE, FL
ZIP 32097
Phone: (904) 261-2405
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PUBLIX SUPER MARKETS INC is a community/retail pharmacy pharmacy in Yulee, 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 1962776286. The provider is registered as an organization entity type.
The provider Is Doing Business As Publix Pharmacy #1406.

The provider's business location address is:

463855 STATE ROAD 200
YULEE, FL
ZIP 32097-639
Phone: (904) 261-2405
Fax: (904) 261-2410

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 10D2088263 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/5/2012 and was last updated on 12/3/2019.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail PharmacyPH26006FLORIDAYes

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
12134071OTHERPK
2004789900MEDICAIDFLORIDA
3004789901MEDICAIDFLORIDA

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: 5/5/2024

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