Publix Super Markets Inc
Organization Active NPI Community/Retail Pharmacy · Lakeland, FL
NPI 1083653992 · NPPES record last updated Jun 24, 2026
Key facts
- NPI
- 1083653992
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PH0010333 (FL)
- Legal business name
- PUBLIX SUPER MARKETS INC
- Practice address
- 3636 Harden Blvd
Lakeland, FL 33803-5938 - Phone
- (863) 400-7874
- Fax
- (863) 701-8189
- NPI assigned
- Jun 6, 2006
- Organization subpart
- No
Authorized official
- Name
- Catherine E Scanlon
- Title
- VP of Pharmacy
- Phone
- (863) 688-1188
Corporate family (same tax ID) 24
Laboratory certificates & supplier records
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|Blood Glucose Monitors/Supplies (Non-Mail Order) | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, FL
Medicare enrollment records
| 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 |
| O20100930002423 | FL | DME Supplier - Pharmacy |
4385644673 | Practice locations: Lakeland, FL |
National Provider Directory
- Tax ID family
- Publix Pharmacy 7413
Locations
3636 Harden Blvd
Lakeland, FL 33803
Phone (863) 400-7874
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PH0010333 | FL | Yes |
Addresses
Primary practice location
3636 Harden Blvd
Lakeland, FL 33803-5938
Mailing address
PO Box 407
Lakeland, FL 33802-0407
Phone (863) 688-1188
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 109992200 | Medicaid | FL | |
| 2008972 | Other | PK |
Other names
- Publix Pharmacy #1854
Other providers in Lakeland, FL
- Alexandra Pruitt
- Psychiatric & Psychological SVCS
- Psychological and Neurobehavioral Services P a
- Psychological Associates of Central Florida
- Publix North Carolina, LP
- Publix Super Markets Inc
- Publix Super Markets Inc
- Publix Super Markets Inc
- Publix Super Markets Inc
- Publix Super Markets Inc
All providers in Lakeland, FL · Community/Retail Pharmacy in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.