MEDICARE: PUBLIX ALABAMA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	112689	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1995540	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396785721
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PUBLIX ALABAMA LLC

Provider Business Mailing Address
First Line	:	PO BOX 639680
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-9680
Country	:	US
Telephone Number	:	863-688-1188
Fax Number	:	863-616-5846

Provider Business Practice Location Address
First Line	:	4045 ATLANTA HWY
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36109-2920
Country	:	US
Telephone Number	:	334-260-7788
Fax Number	:	334-260-7793

Authorized Official
Title or Position	:	VP PHARMACY
Name	:	DAIN RUSK
Credential	:
Telephone Number	:	863-688-1188

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	01/03/2020

Similar Medicare Providers

1952457129 — DR. RACHEL MORVANT SIMS PHARM.D.
Practice Location Address:

4045 ATLANTA HWY
MONTGOMERY, AL
36109-2920

Practice Phone: 334-260-7788
Practice Fax:

1225376627 — MRS. LISA PARAMORE PICKELSIMER
Practice Location Address:

4041 ATLANTA HWY
MONTGOMERY, AL
36109-2920

Practice Phone: 334-260-7788
Practice Fax:

1053659243 — REBECCA BELL
Practice Location Address:

4045 ATLANTA HWY
MONTGOMERY, AL
36109-2920

Practice Phone: 334-260-7788
Practice Fax:

1346661766 — PAMELA PARKER PHARMD
Practice Location Address:

4045 ATLANTA HWY
MONTGOMERY, AL
36109-2920

Practice Phone: 334-260-7782
Practice Fax:

1316362106 — PRI MED PHYSICIANS, INC
Practice Location Address:

4035 ATLANTA HWY
MONTGOMERY, AL
36109-2920

Practice Phone: 334-323-4000
Practice Fax: 334-386-1479

1477087427 — SYED AHMED
Practice Location Address:

4035 ATLANTA HWY
MONTGOMERY, AL
36109-2920

Practice Phone: 334-603-8708
Practice Fax: 334-603-8709

Directions to “PUBLIX ALABAMA LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.