Publix Pharmacy #0474 – Community/Retail Pharmacy, NPI 1679513097

Publix Pharmacy #0474 is a healthcare provider. based in Cincinnati, Ohio. specializing in Community/Retail Pharmacy. The organization holds a License No. PHRE007728 (GA). The NPI Number for Publix Pharmacy #0474 is 1679513097

Main info

Organization
Name
Publix Pharmacy #0474
NPI
1679513097
Phone
(863) 688-1188
Address
PO BOX 639680
Authorized Official
DAIN RUSK VP PHARMACY
Enumeration Date
7 June 2006
Last Update Date
18 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 #0474

  • 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

  • Bradley Park Drive, Fox Chapel, Columbus, Muscogee County, Georgia, 31904, United States

    COLUMBUS, GA 319043625

    Phone: (706) 571-3426

    Fax: (386) 673-8509

    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 2024-09-30 (619 days ago).

Enrollment records

1

Earliest due date

2024-09-30

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
O20100930060364OPharmacyGA2024-09-30

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 vaccine315314$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage304303$0
90480Admn sarscov2 vacc 1 dose198198$0
91322Sarscov2 vac 50 mcg/0.5ml im196196$0
0134AAdm sarscv2 bvl 50mcg/.5ml a8784$0
View full utilization report →

Insurance plans in this area (ZIP 45263)

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Reviews

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Frequently asked questions

Does Publix Pharmacy #0474 share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Publix Pharmacy #0474 uses 1679513097.
Can I rely on Publix Pharmacy #0474 being an active provider?
As of the registry snapshot, Publix Pharmacy #0474 is marked active.
What is Publix Pharmacy #0474's specialty?
The listing groups Publix Pharmacy #0474 with Community/Retail Pharmacy. Clinical services aligned with this taxonomy classification.
Where is Publix Pharmacy #0474 based?
Publix Pharmacy #0474 is tied to Cincinnati, Ohio in the data we show; additional addresses may exist on the full record.
Why does Publix Pharmacy #0474 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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