Publix Pharmacy #1364

LBN: Publix Super Markets Inc
Publix Pharmacy #1364 is an health care organization with primary practice located at 467 Pooler Pkwy , Pooler GA 31322-5102. 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 (912) 330-7308, or through Rusk, Dain via phone (863) 688-1188.

Contact Information

Primary practice address
467 Pooler Pkwy Pooler GA 31322-5102
Fax: (912) 330-7314
Website:
Authorized official contact:
Name: Rusk, Dain

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHRE009709 Georgia

Profile Details

NPI number 1962702696
LBN Legal business name Publix Super Markets Inc
DBA Doing business as Publix Pharmacy #1364
Authorized official Rusk, Dain
Entity Organization
Organization subpart 1 No
Enumeration date Oct 28th, 2010
Last updated Nov 18th, 2019 - about 7 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 1962702696 NPPES
Georgia MEDICAID 003109864A
Georgia Other 2127359

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