Active NPI
Publix Super Markets Inc
- Community/Retail Pharmacy
- Winter Haven, FL
National Provider Identifier
1003063520
On this page
- Key facts
- Authorized official
- Corporate family (same tax ID)15
- Practitioners4
- Laboratory certificates & supplier records
- Medicare participation
- Medicare enrollment records2
- National Provider Directory
- Specialties & licenses3
- Addresses
- Other identifiers3
- Other names1
- NPI Registry JSON
- Other providers in Winter Haven, FL
- Sources for this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PH23480
- Legal business name
- PUBLIX SUPER MARKETS INC
- Practice address
- 884 Cypress Gardens Blvd
Winter Haven, FL 33880-4726 - Phone
- (863) 293-2382
- Fax
- (863) 293-4563
- NPI assigned
- Aug 27, 2008
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Catherine E Scanlon
- Title
- VP of Pharmacy
- Phone
- (863) 688-1188
Corporate family (same tax ID) 15
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Parrish, FL
- NPI 1003010208
-
- Community/Retail Pharmacy
- Winter Garden, FL
- NPI 1003037219
-
- Community/Retail Pharmacy
- St Petersburg, FL
- NPI 1003051582
-
- Pharmacy
- North Miami, FL
- NPI 1003261587
-
- Community/Retail Pharmacy
- Stuart, FL
- NPI 1003525403
-
- Community/Retail Pharmacy
- Miami, FL
- NPI 1003855974
-
- Community/Retail Pharmacy
- Cape Coral, FL
- NPI 1003856956
-
- Community/Retail Pharmacy
- Oviedo, FL
- NPI 1003857509
-
- Community/Retail Pharmacy
- Zephyrhills, FL
- NPI 1013166677
-
- Community/Retail Pharmacy
- Titusville, FL
- NPI 1013214402
-
- Pharmacy
- Casselberry, FL
- NPI 1013233402
-
- Community/Retail Pharmacy
- Pensacola, FL
- NPI 1013466440
-
- Community/Retail Pharmacy
- Saint Cloud, FL
- NPI 1013957323
-
- Community/Retail Pharmacy
- Hollywood, FL
- NPI 1003337783
-
- Community/Retail Pharmacy
- Placida, FL
- NPI 1003559287
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Winter Haven, FL
- NPI 1154589992
-
- Pharmacist
- Winter Haven, FL
- NPI 1972056083
-
- Pharmacist
- Winter Haven, FL
- NPI 1548507403
-
- Pharmacist
- Winter Haven, FL
- NPI 1396083747
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D1019500 | Publix Pharmacy #1204 | Certificate of waiver | Aug 18, 2026 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Publix Super Markets Inc | Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs | Accepts assignment |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, FL
Medicare enrollment records 2
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070110000622 | TX | Part B Supplier - Centralized Flu Biller | 4385644673 |
This NPI is an additional NPI on the enrollment Practice locations: Lakeland, FL |
| O20100930096408 | FL | DME Supplier - Pharmacy | 4385644673 | Practice locations: Winter Haven, FL |
National Provider Directory
National Provider Directory- Tax ID family
- Publix Pharmacy 7413
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Specialties & licenses 3
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PH23480 | FL | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
884 Cypress Gardens Blvd
Winter Haven, FL 33880-4726
Mailing address
PO Box 639680
Cincinnati, OH 45263-9680
Phone (863) 688-1188
Other identifiers 3
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000439101 | Medicaid | FL | |
| 000439100 | Medicaid | FL | |
| 2116742 | Other | PK |
Other names 1
NPPES NPI Registry- Publix Pharmacy #1204
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 17, 2026.
{
"created_epoch": "1219795200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1781654400000",
"number": "1003063520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 639680",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452639680",
"telephone_number": "863-688-1188",
"fax_number": "863-616-5846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "884 CYPRESS GARDENS BLVD",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338804726",
"telephone_number": "863-293-2382",
"fax_number": "863-293-4563"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PUBLIX SUPER MARKETS INC",
"organizational_subpart": "NO",
"enumeration_date": "2008-08-27",
"last_updated": "2026-06-17",
"certification_date": "2026-06-17",
"status": "A",
"authorized_official_last_name": "SCANLON",
"authorized_official_first_name": "CATHERINE",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "VP OF PHARMACY",
"authorized_official_telephone_number": "863-688-1188"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "FL",
"license": "PH23480",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000439101",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000439100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2116742",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Publix Pharmacy #1204",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Publix Pharmacy #1204",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.