NPIMap

Organization Active NPI

Publix Alabama LLC

Doing business as Publix Pharmacy #1377

  • Community/Retail Pharmacy
  • Dothan, AL
National Provider Identifier
1053628826
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
113407 Issued in AL
Legal business name
PUBLIX ALABAMA LLC
Doing business as
Publix Pharmacy #1377
Practice address
4650 W Main St Ste 700
Dothan, AL 36305-9421
Phone
(334) 792-6824
Fax
(334) 824-6988
NPI assigned
Sep 1, 2010
Last updated
May 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Catherine E ScanlonNPI 1467797399
Title
VP of Pharmacy
Phone
(863) 688-1188

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 113407 AL Primary

Addresses

Primary practice location

4650 W Main St Ste 700
Dothan, AL 36305-9421

Mailing address

PO Box 639680
Cincinnati, OH 45263-9680
Phone (863) 688-1188

Other identifiers 3

IdentifierTypeStateIssuer
4521760042MedicaidFL
2126492OtherPK
1053628826MedicaidAL

Other names 1

  • Publix Pharmacy #1377 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070118000254 TX Part B Supplier - Centralized Flu Biller 1355342395 This NPI is an additional NPI on the enrollment
Practice locations: Lakeland, FL; Montgomery, AL; Northport, AL; Pell City, AL; Phenix City, AL; Pinson, AL; Prattville, AL; Tuscaloosa, AL…
O20101130000763 AL DME Supplier - Pharmacy 1355342395 Practice locations: Dothan, AL

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
01D2086985Publix Pharmacy #13774650 West Main Street Suite 700, Dothan, AL 36305Certificate of waiverNov 13, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Publix Alabama, LLC4650 W Main St, Dothan, AL 36305(334) 792-6824 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Sep 1, 2009

National Provider Directory

National Provider Directory
Tax ID family
Publix Alabama LLC96 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4650 W Main St
Ste 700
Dothan, AL 36305
Phone (334) 792-6801

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1053628826",
    "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": "4650 W MAIN ST STE 700",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363059421",
            "telephone_number": "334-792-6824",
            "fax_number": "334-824-6988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIX ALABAMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-01",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "113407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4521760042",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2126492",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053628826",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Publix Pharmacy #1377",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Publix Pharmacy #1377",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.