Publix Pharmacy #0509 – Community/Retail Pharmacy, NPI 1164462545

Publix Pharmacy #0509 is a healthcare provider. based in Cincinnati, Ohio. specializing in Community/Retail Pharmacy. The organization holds a License No. PH0013233 (FL). The NPI Number for Publix Pharmacy #0509 is 1164462545

Main info

Organization
Name
Publix Pharmacy #0509
NPI
1164462545
Phone
(863) 688-1188
Address
PO BOX 639680
Authorized Official
DAIN RUSK VP PHARMACY
Enumeration Date
7 June 2006
Last Update Date
1 February 2022
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 #0509

  • 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

  • West Sunrise Boulevard, Sunrise, Broward County, Florida, 33322:33323:33325, United States

    SUNRISE, FL 333232987

    Phone: (954) 851-1006

    Fax: (954) 851-1012

    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 2024-01-31 (861 days ago).

Enrollment records

1

Earliest due date

2024-01-31

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
O20100930052785OPharmacyFL2024-01-31

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 count42759$0
G0008Administration of influenza virus vaccine146145$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage142141$0
90480Admn sarscov2 vacc 1 dose8484$0
91322Sarscov2 vac 50 mcg/0.5ml im8282$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 is Publix Pharmacy #0509 identified in CMS data?
CMS-hosted NPPES data lists Publix Pharmacy #0509 with NPI 1164462545.
Does CMS list Publix Pharmacy #0509 as active?
Yes — Publix Pharmacy #0509 is active in the NPI listing used on this page.
What is Publix Pharmacy #0509's primary classification?
Community/Retail Pharmacy is the headline specialty for Publix Pharmacy #0509 here. Clinical services aligned with this taxonomy classification.
Where should I expect Publix Pharmacy #0509 on a map?
Expect Cincinnati, Ohio as a primary anchor for Publix Pharmacy #0509 unless the record lists multiple sites.
Why does Publix Pharmacy #0509 have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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