Publix Pharmacy #0352 – Community/Retail Pharmacy, NPI 1083653992

Publix Pharmacy #0352 is a healthcare provider. based in Lakeland, Florida. specializing in Community/Retail Pharmacy. The organization holds a License No. PH0010333 (FL). The NPI Number for Publix Pharmacy #0352 is 1083653992

Main info

Organization
Name
Publix Pharmacy #0352
NPI
1083653992
Phone
(863) 647-3781
Address
3666 Harden Blvd
Authorized Official
DAIN RUSK VP PHARMACY
Enumeration Date
6 June 2006
Last Update Date
9 November 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience74
Completeness80
Years active:20State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for Publix Pharmacy #0352

  • 3666 Harden Blvd

    Lakeland, FL 338035968

    Phone: (863) 647-3781

    Fax: (863) 701-8189

    Type: Location

  • 3666 HARDEN BLVD

    LAKELAND, FL 338035968

    Phone: (863) 647-3781

    Fax: (863) 701-8189

    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

  • Publix, 3636, Harden Boulevard, Lakeland, Polk County, Florida, 33803, United States

    LAKELAND, FL 338035938

    Phone: (863) 400-7874

    Fax: (863) 701-8189

    Type: Location

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 2025-07-31 (313 days ago).

Enrollment records

1

Earliest due date

2025-07-31

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
O20100930002423OPharmacyFL2025-07-31

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
G0008Administration of influenza virus vaccine141140$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage135134$0
K1034Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count12015$0
90480Admn sarscov2 vacc 1 dose9393$0
91322Sarscov2 vac 50 mcg/0.5ml im9191$0
View full utilization report →

Insurance plans in this area (ZIP 33803)

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Reviews

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Frequently asked questions

Is there an official ID for Publix Pharmacy #0352 in U.S. healthcare records?
The official identifier for Publix Pharmacy #0352 is NPI 1083653992.
Is there an active status for Publix Pharmacy #0352?
For scheduling context, Publix Pharmacy #0352 is shown as active in the registry.
What kind of doctor is Publix Pharmacy #0352?
Publix Pharmacy #0352 is associated with Community/Retail Pharmacy in the directory — Clinical services aligned with this taxonomy classification.
Is Publix Pharmacy #0352 associated with Lakeland?
Public fields place Publix Pharmacy #0352 around Lakeland, Florida. Always confirm the exact site before visiting.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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