| Organization Name: | PUBLIX TENNESSEE LLC |
| NPI Number: | 1629406095 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JACQUELINE RUSCH (MANAGER OF MANAGED CARE) |
| Mailing Address: | 635 Paul Huff Pkwy Nw Cleveland |
| State: | TN US |
| Postal Code: | 373122970 |
| Phone Number: | 4234764393 |
| Fax Number: | 4234647666 |
| NPI Enumeration Date: | 10/23/2013 |
| NPI Last Update Date: | 08/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 333600000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | |
| Taxonomy Definition: | 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. |