Publix Pharmacy #1192 – Community/Retail Pharmacy, NPI 1548433774

Publix Pharmacy #1192 is a healthcare provider. based in Lake city, Florida. specializing in Community/Retail Pharmacy. The organization holds a License No. PH23307 (FL). The NPI Number for Publix Pharmacy #1192 is 1548433774

Main info

Organization
Name
Publix Pharmacy #1192
NPI
1548433774
Phone
(386) 719-5451
Address
255 NW COMMONS LOOP
Authorized Official
DAIN RUSK VP PHARMACY
Enumeration Date
9 April 2008
Deactivation Date
3 June 2008
Reactivation Date
17 June 2008
Last Update Date
6 December 2019
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness80
Years active:18State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Publix Pharmacy #1192

  • Commons Loop, Lake City, Columbia County, Florida, United States

    LAKE CITY, FL 320557700

    Phone: (386) 719-5451

    Fax: (386) 719-5456

    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 2026-02-28 (105 days ago).

Enrollment records

1

Earliest due date

2026-02-28

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
O20100930095913OPharmacyFL2026-02-28

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 vaccine222221$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage215214$0
K1034Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count13216$0
90480Admn sarscov2 vacc 1 dose120120$0
91322Sarscov2 vac 50 mcg/0.5ml im118118$0
View full utilization report →

Insurance plans in this area (ZIP 32055)

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Reviews

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Frequently asked questions

Can I use this page to confirm Publix Pharmacy #1192's NPI?
Yes. Publix Pharmacy #1192 is listed with NPI 1548433774 in the public NPI dataset.
Does CMS list Publix Pharmacy #1192 as active?
Yes — Publix Pharmacy #1192 is active in the NPI listing used on this page.
What healthcare role does Publix Pharmacy #1192 hold?
Scheduling teams often label Publix Pharmacy #1192 under Community/Retail Pharmacy. Clinical services aligned with this taxonomy classification.
What address line appears for Publix Pharmacy #1192?
Publix Pharmacy #1192's geographic hint is Lake City, Florida in our summary view.
Is the information about Publix Pharmacy #1192 up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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