Publix Pharmacy #0892

LBN: Publix Super Markets Inc
Publix Pharmacy #0892 is an health care organization with primary practice located at 1512 Highway 74 N , Tyrone GA 30290-1663. 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) 774-2787, or through Rusk, Dain via phone (863) 688-1188.

Contact Information

Primary practice address
1512 Highway 74 N Tyrone GA 30290-1663
Phone: (770) 774-2787
Fax: (770) 774-2791
Website:
Map and Directions
Authorized official contact:
Name: Rusk, Dain
Phone: (863) 688-1188

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHRE008782 Georgia

Profile Details

NPI number 1801835848
LBN Legal business name Publix Super Markets Inc
DBA Doing business as Publix Pharmacy #0892
Authorized official Rusk, Dain
Entity Organization
Organization subpart 1 No
Enumeration date Jun 5th, 2006
Last updated Nov 20th, 2019 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801835848 NPPES
Other 2015489 PK
MEDICAID 333617816A PK

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