Publix Pharmacy #1275 – Pharmacy, NPI 1043546161

Publix Pharmacy #1275 is a healthcare provider. based in Mount dora, Florida. specializing in Pharmacy. The organization holds a License No. PH24275 (FL). The NPI Number for Publix Pharmacy #1275 is 1043546161

Main info

Organization
Name
Publix Pharmacy #1275
NPI
1043546161
Phone
(352) 383-2352
Address
6551 N ORANGE BLOSSOM TRL STE 155
Authorized Official
DAIN RUSK VP PHARMACY
Enumeration Date
23 October 2009
Last Update Date
6 December 2019
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness80
Years active:16State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for Publix Pharmacy #1275

  • 6551 N ORANGE BLOSSOM TRL STE 155

    MOUNT DORA, FL 327577009

    Phone: (352) 383-2352

    Fax: (352) 383-5432

    Type: Location

  • Boom Box Buns, 1324, Main Street, Main Street Business District, Over-the-Rhine, Cincinnati, Hamilton County, Ohio, 45202, United States

    CINCINNATI, OH 452639680

    Phone: (863) 688-1188

    Fax: (863) 616-5846

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2026-05-31 (15 days ago).

Enrollment records

1

Earliest due date

2026-05-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20100930099762OPharmacyFL2026-05-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
K1034Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count23926$0
G0008Administration of influenza virus vaccine213210$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage208205$0
90480Admn sarscov2 vacc 1 dose100100$0
91322Sarscov2 vac 50 mcg/0.5ml im8585$0
View full utilization report →

Insurance plans in this area (ZIP 32757)

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Reviews

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Frequently asked questions

Is there an official ID for Publix Pharmacy #1275 in U.S. healthcare records?
The official identifier for Publix Pharmacy #1275 is NPI 1043546161.
Is there an active status for Publix Pharmacy #1275?
For scheduling context, Publix Pharmacy #1275 is shown as active in the registry.
What clinical focus is listed for Publix Pharmacy #1275?
At a glance, Publix Pharmacy #1275 is tied to Pharmacy. Clinical services aligned with this taxonomy classification.
Is Publix Pharmacy #1275 associated with Mount Dora?
Public fields place Publix Pharmacy #1275 around Mount Dora, Florida. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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