NPIMap

Organization Active NPI

Publix Tennessee LLC

  • Community/Retail Pharmacy
  • Hendersonville, TN
National Provider Identifier
1366482705
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
3866 Issued in TN
Legal business name
PUBLIX TENNESSEE LLC
Practice address
110 Indian Lake Blvd
Hendersonville, TN 37075-6206
Phone
(615) 264-2901
Fax
(615) 264-6451
NPI assigned
Jun 7, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Catherine E Scanlon
Title
VP Pharmacy
Phone
(863) 688-1188

Corporate family (same tax ID) 24

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Derived by NPIMap

These 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

SupplierSuppliesMedicare assignment
Publix Pharmacy #119110 Indian Lake Blvd, Hendersonville, TN 37075-6206(615) 264-2901 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Sep 1, 2009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, TN2 enrollments

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20070111000608 TX Part B Supplier - Centralized Flu Biller 5597765776 This NPI is an additional NPI on the enrollment
Practice locations: Lebanon, TN; Antioch, TN; Mt Juliet, TN; Murfreesboro, TN; Nashville, TN; Ooltewah, TN; Smyrna, TN; Spring Hill, TN…
O20100930007156 TN DME Supplier - Pharmacy 5597765776 Practice locations: Hendersonville, TN

National Provider Directory

National Provider Directory
Tax ID family
Publix Pharmacy 0119 (63 organizations share this tax ID)

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 3866 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

110 Indian Lake Blvd
Hendersonville, TN 37075-6206

Mailing address

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

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
Q035766MedicaidTN
2093897OtherPK

Other names 1

NPPES NPI Registry
  • Publix Pharmacy #0119 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 25, 2026.

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782345600000",
    "number": "1366482705",
    "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": "110 INDIAN LAKE BLVD",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370756206",
            "telephone_number": "615-264-2901",
            "fax_number": "615-264-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIX TENNESSEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A",
        "authorized_official_last_name": "SCANLON",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VP 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": "TN",
            "license": "3866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q035766",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2093897",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Publix Pharmacy #0119",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Publix Pharmacy #0119",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hendersonville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.

Verify at the official NPI Registry.