Publix Pharmacy #1793 – Community/Retail Pharmacy, NPI 1669412003

Publix Pharmacy #1793 is a healthcare provider. based in Altamonte springs, Florida. specializing in Community/Retail Pharmacy. The organization holds a License No. PH0009486 (FL). The NPI Number for Publix Pharmacy #1793 is 1669412003

Main info

Organization
Name
Publix Pharmacy #1793
NPI
1669412003
Phone
(407) 682-5555
Address
951 N STATE ROAD 434
Authorized Official
DAIN RUSK VP PHARMACY
Enumeration Date
7 June 2006
Last Update Date
7 December 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 #1793

  • 951 N STATE ROAD 434

    ALTAMONTE SPRINGS, FL 327147026

    Phone: (407) 682-5555

    Fax: (407) 682-2299

    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

  • 1005 N. STATE ROAD 434

    STE 1020

    ALTAMONTE SPRINGS, FL 327147038

    Phone: (407) 682-5555

    Fax: (407) 682-2299

    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 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
O20100930077874OPharmacyFL2026-02-28

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 vaccine209206$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage207204$0
90480Admn sarscov2 vacc 1 dose6767$0
91322Sarscov2 vac 50 mcg/0.5ml im6262$0
0124AAdm sarscv2 bvl 30mcg/.3ml a1414$0
View full utilization report →

Insurance plans in this area (ZIP 32714)

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Reviews

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Frequently asked questions

What unique ID ties claims to Publix Pharmacy #1793?
NPI 1669412003 is assigned to Publix Pharmacy #1793 under the national enumeration system.
Is Publix Pharmacy #1793's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is Publix Pharmacy #1793?
The page reflects Community/Retail Pharmacy for Publix Pharmacy #1793. Clinical services aligned with this taxonomy classification.
Where does public data place Publix Pharmacy #1793?
The snapshot lists Altamonte Springs, Florida for Publix Pharmacy #1793; download NPPES for the complete set.
How can I contact Publix Pharmacy #1793?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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