Publix Pharmacy #0239 – Community/Retail Pharmacy, NPI 1629019120

Publix Pharmacy #0239 is a healthcare provider. based in Cincinnati, Ohio. specializing in Community/Retail Pharmacy. The organization holds a License No. PH0016003 (FL). The NPI Number for Publix Pharmacy #0239 is 1629019120

Main info

Organization
Name
Publix Pharmacy #0239
NPI
1629019120
Phone
(863) 688-1188
Address
PO BOX 639680
Authorized Official
DAIN RUSK VP PHARMACY
Enumeration Date
8 June 2006
Last Update Date
21 November 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

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Provider Addresses for Publix Pharmacy #0239

  • 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

  • 10155, West Oakland Park Boulevard, Sunrise, Broward County, Florida, 33351, United States

    SUNRISE, FL 333516918

    Phone: (954) 746-1002

    Fax: (954) 748-2035

    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
O20100930014981OPharmacyFL2024-01-31

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
G0008Administration of influenza virus vaccine107107$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage9999$0
90480Admn sarscov2 vacc 1 dose4040$0
91322Sarscov2 vac 50 mcg/0.5ml im3737$0
G0009Administration of pneumococcal vaccine2121$0
View full utilization report →

Insurance plans in this area (ZIP 45263)

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Reviews

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Frequently asked questions

Can I cross-check Publix Pharmacy #0239 using NPI 1629019120?
NPI 1629019120 belongs to Publix Pharmacy #0239; compare other details if you need extra assurance.
Would Publix Pharmacy #0239 appear as active to a payer?
You can treat Publix Pharmacy #0239 as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for Publix Pharmacy #0239?
At a glance, Publix Pharmacy #0239 is tied to Community/Retail Pharmacy. Clinical services aligned with this taxonomy classification.
Is Publix Pharmacy #0239 associated with Cincinnati?
Public fields place Publix Pharmacy #0239 around Cincinnati, Ohio. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for Publix Pharmacy #0239 is noted as June 8, 2006 where the registry provides it.

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