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Contact Information

PUBLIX TENNESSEE LLC
665 SOUTH MT.JULIET RD.
MOUNT JULIET, TN37122
 Phone: 615-773-0255
 Fax: 615-903-9053
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PUBLIX TENNESSEE LLC

NPI # 1750610515
LBN Legal business name PUBLIX TENNESSEE LLC
Authorized official DAIN RUSK - (VP PHARMACY)
Entity Organization
Organization subpart 1 No
Enumeration date 12/08/2009
Last updated 02/28/2024 - About 2 years ago
Identifiers
TN License # 4715
Other 2123032 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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