Publix Pharmacy #1201 – Community/Retail Pharmacy, NPI 1124068507

Publix Pharmacy #1201 is a healthcare provider. based in Cincinnati, Ohio. specializing in Community/Retail Pharmacy. The organization holds a License No. PH18819 (FL). The NPI Number for Publix Pharmacy #1201 is 1124068507

Main info

Organization
Name
Publix Pharmacy #1201
NPI
1124068507
Phone
(863) 688-1188
Address
PO BOX 639680
Authorized Official
DAIN RUSK VP PHARMACY
Enumeration Date
7 June 2006
Last Update Date
13 August 2020
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

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Provider Addresses for Publix Pharmacy #1201

  • 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

  • State Highway 500, Ocala, Marion County, Florida, 37775, United States

    UNIT 111

    OCALA, FL 344817823

    Phone: (352) 291-0372

    Fax: (352) 291-0384

    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 2026-04-30 (40 days ago).

Enrollment records

1

Earliest due date

2026-04-30

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
O20100930084435OPharmacyFL2026-04-30

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 vaccine1,1371,133$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage1,1091,105$0
90480Admn sarscov2 vacc 1 dose548544$0
91322Sarscov2 vac 50 mcg/0.5ml im505503$0
0134AAdm sarscv2 bvl 50mcg/.5ml a131131$0
View full utilization report →

Insurance plans in this area (ZIP 45263)

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Reviews

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Frequently asked questions

How do I look up Publix Pharmacy #1201 by NPI?
Use NPI 1124068507 when you need to reference Publix Pharmacy #1201 in forms, claims, or directories.
Is Publix Pharmacy #1201 active in the national directory?
Publix Pharmacy #1201's public NPI profile is in an active state.
What kind of provider is Publix Pharmacy #1201?
The page reflects Community/Retail Pharmacy for Publix Pharmacy #1201. Clinical services aligned with this taxonomy classification.
Where is Publix Pharmacy #1201's primary listing?
We display Cincinnati, Ohio because that is what the record indicates for Publix Pharmacy #1201.
Is Publix Pharmacy #1201 a real provider?
This page reflects official NPPES data for NPI 1124068507. Always confirm identity and privileges with the practice and licensing boards.

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