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General NPI Number Information
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NPI Number | 1679958128
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Entity Type | Organization
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Legal Business Name | PUBLIX
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 2840 DAVID WALKER DR
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City | EUSTIS
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State | FL
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Zip | 32726-6172
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Country | US
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Telephone | 352-357-9168
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Fax |
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Provider Business Mailing Address
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Address Line | 2840 DAVID WALKER DR
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City | EUSTIS
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State | FL
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Zip | 32726-6172
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Country | US
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Telephone | 352-357-9168
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Fax |
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Authorized Official
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Title or Position | VP BEN ADM AND ASSISTANT SECRETARY
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Name | LINDA KANE
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Credential |
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Telephone | 863-688-1188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS0053563
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License Number State | FL
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