Active NPI
Publix Super Markets Inc
- Community/Retail Pharmacy
- St Petersburg, FL
National Provider Identifier
1215977624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PH0017191
- Legal business name
- PUBLIX SUPER MARKETS INC
- Doing business as
- Publix Pharmacy #0640
- Practice address
- 200 37TH Ave N
St Petersburg, FL 33704-1416 - Phone
- (727) 895-7767
- Fax
- (727) 895-7731
- NPI assigned
- Jun 7, 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 | PH0017191 | FL | Primary |
Addresses
Primary practice location
200 37TH Ave N
St Petersburg, FL 33704-1416
Mailing address
PO Box 639680
Cincinnati, OH 45263-9680
Phone (863) 688-1188
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 022255100 | Medicaid | FL | |
| 2013366 | Other | PK |
Other names 1
- Publix Pharmacy #0640
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 |
| O20100930090524 | FL | DME Supplier - Pharmacy | 4385644673 | Practice locations: Saint Petersburg, FL |
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 | Accepts assignment |
National Provider Directory
National Provider DirectoryLocations
200 37th Ave N
St Petersburg, FL 33704
Phone (727) 821-7568
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1782086400000",
"number": "1215977624",
"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": "200 37TH AVE N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337041416",
"telephone_number": "727-895-7767",
"fax_number": "727-895-7731"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PUBLIX SUPER MARKETS INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-07",
"last_updated": "2026-06-22",
"certification_date": "2026-06-22",
"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": "PH0017191",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "022255100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2013366",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Publix Pharmacy #0640",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Publix Pharmacy #0640",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.