NPIMap

Organization Active NPI

Publix Super Markets Inc

  • Community/Retail Pharmacy
  • Villa Rica, GA
National Provider Identifier
1447299482
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE008805 Issued in GA
Legal business name
PUBLIX SUPER MARKETS INC
Practice address
103 Mirror Lake Connector Ste 200
Villa Rica, GA 30180-3250
Phone
(678) 840-8788
Fax
(678) 840-8786
NPI assigned
Jun 5, 2006
Organization subpart
No

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, GA2 enrollments

Enrollment records 2

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
O20100930005928 GA DME Supplier - Pharmacy 4385644673 Practice locations: Villa Rica, GA

National Provider Directory

National Provider Directory
Tax ID family
Publix Pharmacy 74131,155 organizations share this tax ID, including this one

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.

View all 24

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHRE008805 GA Primary

Addresses

Primary practice location

103 Mirror Lake Connector Ste 200
Villa Rica, GA 30180-3250

Mailing address

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

Other practice location 1

2000 Mirror Lake Blvd
Villa Rica, GA 30180-2124
Phone (678) 840-8788

Other identifiers 3

IdentifierTypeStateIssuer
2015543OtherPK
253206699AMedicaidGA
PHRE011166OtherGASTATE PHARMACY LICENSE

Other names 1

  • Publix Pharmacy #2011 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 Jul 7, 2026.

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783382400000",
    "number": "1447299482",
    "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": "103 MIRROR LAKE CONNECTOR STE 200",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301803250",
            "telephone_number": "678-840-8788",
            "fax_number": "678-840-8786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Mirror Lake Blvd",
            "address_purpose": "LOCATION",
            "city": "Villa Rica",
            "state": "GA",
            "postal_code": "301802124",
            "country_code": "US",
            "telephone_number": "678-840-8788",
            "fax_number": "678-840-8786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PUBLIX SUPER MARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-05",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "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": "GA",
            "license": "PHRE008805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2015543",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253206699A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY LICENSE",
            "identifier": "PHRE011166",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Publix Pharmacy #2011",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Villa Rica, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.