Active NPI
Publix Super Markets Inc
- Community/Retail Pharmacy
- Bradenton, FL
National Provider Identifier
1124067996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PH0017912
- Legal business name
- PUBLIX SUPER MARKETS INC
- Practice address
- 3913 Manatee Ave W
Bradenton, FL 34205-1715 - Phone
- (941) 746-5833
- Fax
- (941) 746-5584
- NPI assigned
- Jun 6, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Catherine E Scanlon
- Title
- VP of Pharmacy
- Phone
- (863) 688-1188
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PH0017912 | FL | Primary |
Addresses
Primary practice location
3913 Manatee Ave W
Bradenton, FL 34205-1715
Mailing address
PO Box 639680
Cincinnati, OH 45263-9680
Phone (863) 688-1188
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 022788900 | Medicaid | FL | |
| 2013968 | Other | PK |
Other names 1
- Publix Pharmacy #0780
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, FL
Enrollment records 2
| 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 |
| O20100930040064 | FL | DME Supplier - Pharmacy | 4385644673 | Practice locations: Bradenton, FL |
National Provider Directory
National Provider Directory- Tax ID family
- Publix Pharmacy 7413
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Community/Retail Pharmacy
- Jacksonville, FL
- NPI 1093754046
-
- Community/Retail Pharmacy
- Winter Haven, FL
- NPI 1093754053
-
- Community/Retail Pharmacy
- Jacksonville, FL
- NPI 1104134535
-
- Community/Retail Pharmacy
- Bradenton, FL
- NPI 1104154822
-
- Community/Retail Pharmacy
- Arcadia, FL
- NPI 1104274554
-
- Community/Retail Pharmacy
- Fort Myers, FL
- NPI 1104866417
-
- Community/Retail Pharmacy
- Mount Dora, FL
- NPI 1104866516
-
- Community/Retail Pharmacy
- Ormond Beach, FL
- NPI 1104866961
-
- Community/Retail Pharmacy
- Ocoee, FL
- NPI 1114184371
-
- Community/Retail Pharmacy
- St Augustine, FL
- NPI 1124068069
-
- Community/Retail Pharmacy
- Ocala, FL
- NPI 1124068507
-
- Community/Retail Pharmacy
- Sun City Center, FL
- NPI 1124068531
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
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.
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 |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1782172800000",
"number": "1124067996",
"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": "3913 MANATEE AVE W",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342051715",
"telephone_number": "941-746-5833",
"fax_number": "941-746-5584"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PUBLIX SUPER MARKETS INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-06",
"last_updated": "2026-06-23",
"certification_date": "2026-06-23",
"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": "PH0017912",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "022788900",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2013968",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Publix Pharmacy #0780",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Publix Pharmacy #0780",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.