NPI | 1760745061 |
---|---|
Doing Business As | PUBLIX PHARMACY #1405 |
Entity Type | Organization |
Authorized Contact | DAIN RUSK VP Pharmacy 863-688-1188 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH26235) |
Additional Taxonomies | 333600000X Pharmacy |
Enumeration Date | 2012-06-21 |
Last Update Date | 2019-12-03 |