NPIMap

Organization Active NPI

Publix Super Markets, Inc.

Doing business as Publix Pharmacy #1793

  • Community/Retail Pharmacy
  • Altamonte Springs, FL
National Provider Identifier
1841924859
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PUBLIX SUPER MARKETS, INC.
Doing business as
Publix Pharmacy #1793
Practice address
1005 N. State Road 434, Suite 1020
Altamonte Springs, FL 32714
Phone
(407) 551-5025
Fax
(863) 616-5810
NPI assigned
Jul 14, 2022
Last updated
Jul 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dain Rusk
Title
VP, Pharmacy
Phone
(863) 688-1188

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1005 N. State Road 434, Suite 1020
Altamonte Springs, FL 32714

Mailing address

PO Box 639680
Cincinnati, OH 45263-9680
Phone (186) 368-8118

Other names 1

  • Publix Pharmacy #1793 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070110000622 TX Part B Supplier - Centralized Flu Biller 4385644673 This NPI is an additional NPI on the enrollment
Practice locations: Lakeland, FL

National Provider Directory

National Provider Directory
Tax ID family
Publix Pharmacy 73991,161 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688342400000",
    "number": "1841924859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639680",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639680",
            "telephone_number": "186-368-8118",
            "fax_number": "863-616-5810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 N. STATE ROAD 434, SUITE 1020",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "32714",
            "telephone_number": "407-551-5025",
            "fax_number": "863-616-5810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIX SUPER MARKETS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-14",
        "last_updated": "2023-07-03",
        "certification_date": "2023-06-20",
        "status": "A",
        "authorized_official_last_name": "RUSK",
        "authorized_official_first_name": "DAIN",
        "authorized_official_title_or_position": "VP, PHARMACY",
        "authorized_official_telephone_number": "863-688-1188"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Publix Pharmacy #1793",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Publix Pharmacy #1793",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.