Publix Pharmacy #0805 – Community/Retail Pharmacy, NPI 1689614067

Publix Pharmacy #0805 is a healthcare provider. based in Cincinnati, Ohio. specializing in Community/Retail Pharmacy. The organization holds a License No. PH0018728 (FL). The NPI Number for Publix Pharmacy #0805 is 1689614067

Main info

Organization
Name
Publix Pharmacy #0805
NPI
1689614067
Phone
(863) 688-1188
Address
PO BOX 639680
Authorized Official
DAIN RUSK VP PHARMACY
Enumeration Date
7 June 2006
Last Update Date
6 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

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Provider Addresses for Publix Pharmacy #0805

  • 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

  • Coconut Creek Parkway, Hammondville, Margate, Broward County, Florida, 33063, United States

    COCONUT CREEK, FL 330633944

    Phone: (954) 975-4377

    Fax: (954) 975-6197

    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 (860 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
O20100930073051OPharmacyFL2024-01-31

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 count44770$0
G0008Administration of influenza virus vaccine167167$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage163163$0
90480Admn sarscov2 vacc 1 dose4645$0
91322Sarscov2 vac 50 mcg/0.5ml im3837$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 #0805 identified in CMS data?
CMS-hosted NPPES data lists Publix Pharmacy #0805 with NPI 1689614067.
Does the file indicate Publix Pharmacy #0805 is practicing under active NPI?
Directory data currently reports Publix Pharmacy #0805 as active.
What taxonomy line describes Publix Pharmacy #0805?
For research purposes, treat Publix Pharmacy #0805 as Community/Retail Pharmacy in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for Publix Pharmacy #0805?
Publix Pharmacy #0805's geographic hint is Cincinnati, Ohio in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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