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PUBLIX SUPER MARKETS INC NPI 1003261587


NPI Information

NPI: 1003261587
Provider Name: PUBLIX SUPER MARKETS INC

Doing Business As: PUBLIX PHARMACY #1003

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 10D2116803

Address:
12855 NE 6TH AVE
NORTH MIAMI, FL
ZIP 33161
Phone: (305) 891-7054
Get Directions

PUBLIX SUPER MARKETS INC is a pharmacy in North Miami, FL. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. PUBLIX SUPER MARKETS INC NPI is 1003261587. The provider is registered as an organization entity type.
The provider Is Doing Business As Publix Pharmacy #1003.

The provider's business location address is:

12855 NE 6TH AVE
NORTH MIAMI, FL
ZIP 33161-714
Phone: (305) 891-7054
Fax: (786) 646-9782

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 10D2116803 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/3/2016 and was last updated on 12/6/2019.


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
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacyPH30293FLORIDAYes
33336C0003XPharmacyCommunity/Retail PharmacyNo

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
1018496100MEDICAIDFLORIDA
2018496101MEDICAIDFLORIDA
32159869OTHERPK

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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