Organization Active NPI

Publix Super Markets Inc

  • Community/Retail Pharmacy
  • Winter Haven, FL
National Provider Identifier
1003063520
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH23480 Issued in FL
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.

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1019500Publix Pharmacy #1204884 Cypress Gardens Blvd, Winter Haven, FL 33880Certificate of waiverAug 18, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Publix Super Markets Inc884 Cypress Gardens Blvd, Winter Haven, FL 33880-4726(863) 293-2382 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Dec 7, 2016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL2 enrollments

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
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 (1,155 organizations share this tax ID)

Networks

  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)
  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PH23480 FL Primary

Addresses

NPPES NPI Registry

Primary 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
IdentifierTypeStateIssuer
000439101MedicaidFL
000439100MedicaidFL
2116742OtherPK

Other names 1

NPPES NPI Registry
  • Publix Pharmacy #1204 Doing business as

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.

Verify at the official NPI Registry.