Publix Pharmacy #1064
LBN: Publix Super Markets Inc
Publix Pharmacy #1064 is an health care organization with primary practice located at 120 Prominence Point Pkwy , Canton GA 30114-9008. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Publix Super Markets Inc can be contacted via phone (770) 720-4825, or through Rusk, Dain via phone (863) 688-1188.
Contact Information
Primary practice address
120 Prominence Point Pkwy
Canton GA 30114-9008
Phone: (770) 720-4825
Fax: (770) 882-0162
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PHRE008797 | Georgia |
Profile Details
| NPI number | 1629017660 |
|---|---|
| LBN Legal business name | Publix Super Markets Inc |
| DBA Doing business as | Publix Pharmacy #1064 |
| Authorized official | Rusk, Dain |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 5th, 2006 |
| Last updated | Oct 27th, 2022 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629017660 | NPPES |
| Other | 2015539 | PK | |
| MEDICAID | 444039876A | PK |
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