Publix Super Markets Inc
Organization Active NPI Community/Retail Pharmacy · Ponte Vedra Beach, FL
NPI 1366481301 · NPPES record last updated Jun 25, 2026
Key facts
- NPI
- 1366481301
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PH0021316 (FL)
- Legal business name
- PUBLIX SUPER MARKETS INC
- Practice address
- 3777 Palm Valley Rd
Ponte Vedra Beach, FL 32082-4115 - Phone
- (904) 273-6667
- Fax
- (904) 273-6575
- NPI assigned
- Jun 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Catherine E Scanlon
- Title
- VP of Pharmacy
- Phone
- (863) 688-1188
Corporate family (same tax ID) 24
Practitioners 1
-
Lee Watson, RPH
Laboratory certificates & supplier records
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 |
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 |
| O20100930020572 | FL | DME Supplier - Pharmacy | 4385644673 | Practice locations: Ponte Vedra Beach, FL |
National Provider Directory
- Tax ID family
- Publix Pharmacy 7413
Locations
3777 Palm Valley Rd
Ponte Vedra Beach, FL 32082
Phone (904) 273-6667
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PH0021316 | FL | Yes |
Addresses
Primary practice location
3777 Palm Valley Rd
Ponte Vedra Beach, FL 32082-4115
Mailing address
PO Box 639680
Cincinnati, OH 45263-9680
Phone (863) 688-1188
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 030852800 | Medicaid | FL | |
| 030852801 | Medicaid | FL | |
| 2004357 | Other | PK |
Other names
- Publix Pharmacy #1028
Other providers in Ponte Vedra Beach, FL
- Premier Physical Therapy and Rehabilitation of Jacksonville, Inc
- Jessica Preston
- Primary Care Solutions Jacksonville LLC
- Sharon Angela Prince
- Lauren Ashley Pryor
- Publix Super Markets, Inc.
- Stephen M Pullen
- PVPT, Inc.
- Tamara Nicole Quant
- Nancy Ellen Quick
All providers in Ponte Vedra Beach, 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 25, 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.