NPIMap

Publix Super Markets Inc

Organization Active NPI Community/Retail Pharmacy · Kennesaw, GA

NPI 1477593929 · NPPES record last updated Jun 30, 2026

Key facts

NPI
1477593929
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
PHRE008496 (GA)
Legal business name
PUBLIX SUPER MARKETS INC
Practice address
1635 Old 41 Hwy NW
Kennesaw, GA 30152-4480
Phone
(770) 426-6860
Fax
(770) 426-8495
NPI assigned
Jun 6, 2006
Organization subpart
No

Authorized official

Name
Catherine E Scanlon
Title
VP of Pharmacy
Phone
(863) 688-1188

Corporate family (same tax ID) 24

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Publix Super Markets Inc
1635 Old 41 Hwy NW, Kennesaw, GA 30152 · (770) 426-6860		 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignment
Participating since Dec 7, 2016

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in TX, GA

Medicare enrollment records

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
O20100930077968 GA DME Supplier - Pharmacy 4385644673 Practice locations: Kennesaw, GA

National Provider Directory

Tax ID family
Publix Pharmacy 7413 (1,155 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHRE008496 GA Yes

Addresses

Primary practice location

1635 Old 41 Hwy NW
Kennesaw, GA 30152-4480

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
00899676EMedicaidGA
2014321OtherPK

Other names

  • Publix Pharmacy #0769 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 30, 2026.

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782777600000",
    "number": "1477593929",
    "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": "1635 OLD 41 HWY NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524480",
            "telephone_number": "770-426-6860",
            "fax_number": "770-426-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIX SUPER MARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "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": "PHRE008496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00899676E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2014321",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Publix Pharmacy #0769",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Publix Pharmacy #0769",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kennesaw, GA

All providers in Kennesaw, GA · Community/Retail Pharmacy in Georgia

Sources for this page

Verify at the official NPI Registry.