Publix Super Markets Inc
Organization Active NPI Community/Retail Pharmacy · Jacksonville, FL
NPI 1104134535 · NPPES record last updated Jun 17, 2026
Key facts
- NPI
- 1104134535
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PH24938 (FL)
- Legal business name
- PUBLIX SUPER MARKETS INC
- Practice address
- 5858 Atlantic Blvd
Jacksonville, FL 32207-2223 - Phone
- (904) 721-3488
- Fax
- (904) 721-3496
- NPI assigned
- Sep 20, 2010
- 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 Pharmacy #1283 |
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 |
| O20101112000288 | FL | DME Supplier - Pharmacy | 4385644673 | Practice locations: Jacksonville, FL |
National Provider Directory
- Tax ID family
- Publix Pharmacy 7413
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PH24938 | FL | Yes |
Addresses
Primary practice location
5858 Atlantic Blvd
Jacksonville, FL 32207-2223
Mailing address
PO Box 639680
Cincinnati, OH 45263-9680
Phone (863) 688-1188
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002817300 | Medicaid | FL | |
| 2126810 | Other | PK |
Other names
- Publix Pharmacy #1283
Other providers in Jacksonville, FL
- PT Works LLC
- Dinesh Pubbi
- Public Square Pharmacy LLC
- Public Square Pharmacy LLC
- Publix Super Markets Inc
- Publix Super Markets Inc
- Publix Super Markets Inc
- Publix Super Markets Inc
- Publix Super Markets Inc
- Publix Super Markets Inc
All providers in Jacksonville, 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 17, 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.