Publix Pharmacy #0684 – Community/Retail Pharmacy, NPI 1972542827

Publix Pharmacy #0684 is a healthcare provider. based in Clermont, Florida. specializing in Community/Retail Pharmacy. The organization holds a License No. PH0016723 (FL). The NPI Number for Publix Pharmacy #0684 is 1972542827

Main info

Organization
Name
Publix Pharmacy #0684
NPI
1972542827
Phone
(352) 243-0785
Address
17445 US HIGHWAY 192 STE 11
Authorized Official
DAIN RUSK VP PHARMACY
Enumeration Date
6 June 2006
Last Update Date
3 December 2019
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness80
Years active:20State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for Publix Pharmacy #0684

  • 17445 US HIGHWAY 192 STE 11

    CLERMONT, FL 347147016

    Phone: (352) 243-0785

    Fax: (352) 243-0815

    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 2025-07-31 (314 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
O20100930002461OPharmacyFL2025-07-31

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
K1034Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count17227$0
G0008Administration of influenza virus vaccine8888$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage8383$0
90480Admn sarscov2 vacc 1 dose4444$0
91322Sarscov2 vac 50 mcg/0.5ml im4040$0
View full utilization report →

Insurance plans in this area (ZIP 34714)

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Reviews

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Frequently asked questions

Does Publix Pharmacy #0684 have a public NPI I can cite?
Public records show Publix Pharmacy #0684 under NPI 1972542827.
Should I treat Publix Pharmacy #0684 as an active provider?
Patients and plans typically see Publix Pharmacy #0684 as active in the national extract.
Which specialty label fits Publix Pharmacy #0684?
NPPES ties Publix Pharmacy #0684 to Community/Retail Pharmacy in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is Publix Pharmacy #0684 tied to Clermont, Florida?
If you are local to Clermont, Florida, Publix Pharmacy #0684 may be relevant to your search.
Can I export Publix Pharmacy #0684's record?
You can download the official NPPES record; we summarize key fields for readability.

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