Active NPI
Publix Super Markets, Inc.
- Community/Retail Pharmacy
- Port Saint Lucie, FL
National Provider Identifier
1316743495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- PUBLIX SUPER MARKETS, INC.
- Doing business as
- Publix Pharmacy #2092
- Practice address
- 12407 SW Community Blvd
Port Saint Lucie, FL 34987 - Phone
- (772) 446-8515
- Fax
- (772) 577-7223
- NPI assigned
- Feb 20, 2025
- 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 | Primary |
Addresses
Primary practice location
12407 SW Community Blvd
Port Saint Lucie, FL 34987
Mailing address
PO Box 407
Lakeland, FL 33802-0407
Phone (863) 688-1188
Other names 1
- Publix Pharmacy #2092
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 |
| O20250819003049 | FL | DME Supplier - Pharmacy | 4385644673 | Practice locations: Port Saint Lucie, 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|Blood Glucose Monitors/Supplies (Non-Mail Order) | Accepts assignment |
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 1306603360
-
- Community/Retail Pharmacy
- Ocoee, FL
- NPI 1306885173
-
- Community/Retail Pharmacy
- Plantation, FL
- NPI 1306886718
-
- Community/Retail Pharmacy
- Weston, FL
- NPI 1306886742
-
- Community/Retail Pharmacy
- Lynn Haven, FL
- NPI 1306886783
-
- Community/Retail Pharmacy
- Lake Mary, FL
- NPI 1306887898
-
- Community/Retail Pharmacy
- Indian Harbour Beach, FL
- NPI 1306897178
-
- Community/Retail Pharmacy
- Coral Springs, FL
- NPI 1316128283
-
- Community/Retail Pharmacy
- Deland, FL
- NPI 1316191505
-
- Community/Retail Pharmacy
- Hialeah, FL
- NPI 1316225139
-
- Community/Retail Pharmacy
- Melbourne, FL
- NPI 1316880800
-
- Community/Retail Pharmacy
- Melbourne, FL
- NPI 1316986185
Locations
12407 SW Community Blvd
Port Saint Lucie, FL 34987
Phone (772) 446-8515
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740009600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1783468800000",
"number": "1316743495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 407",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338020407",
"telephone_number": "863-688-1188",
"fax_number": "863-616-5810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12407 SW COMMUNITY BLVD",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "34987",
"telephone_number": "772-446-8515",
"fax_number": "772-577-7223"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PUBLIX SUPER MARKETS, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2025-02-20",
"last_updated": "2026-07-08",
"certification_date": "2026-07-08",
"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": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Publix Pharmacy #2092",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Publix Pharmacy #2092",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.