NPIMap

Publix Super Markets Inc

Organization Active NPI Community/Retail Pharmacy · Vero Beach, FL

NPI 1124068895 · NPPES record last updated Jun 16, 2026

Key facts

NPI
1124068895
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
PH0015982 (FL)
Legal business name
PUBLIX SUPER MARKETS INC
Practice address
415 21St St
Vero Beach, FL 32960-5455
Phone
(772) 562-0541
Fax
(772) 562-0789
NPI assigned
Jun 8, 2006
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Laboratory certificates & supplier records

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Publix Super Markets, Inc
415 21St St, Vero Beach, FL 32960-5455 · (772) 562-0541		 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignment
Participating since Dec 7, 2016

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in TX, FL

Medicare enrollment records

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
O20100930090489 FL DME Supplier - Pharmacy 4385644673 Practice locations: Vero Beach, FL

National Provider Directory

Tax ID family
Publix Pharmacy 7413 (1,155 organizations share this tax ID)

Locations

415 21st St
Vero Beach, FL 32960
Phone (772) 257-0610

Networks

  • Optimum HealthCare HMO Network
    Plans: 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 Network
    Plans: 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

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PH0015982 FL Yes

Addresses

Primary practice location

415 21St St
Vero Beach, FL 32960-5455

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
106390100MedicaidFL
2011555OtherPK

Other names

  • Publix Pharmacy #1150 Doing business as

Other providers in Vero Beach, FL

All providers in Vero Beach, FL · Community/Retail Pharmacy in Florida

Sources for this page

Verify at the official NPI Registry.