NPIMap

Organization Active NPI

Publix Tennessee, LLC

  • Community/Retail Pharmacy
  • Johnson City, TN
National Provider Identifier
1497345573
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PUBLIX TENNESSEE, LLC
Practice address
509 N State of Franklin Rd Ste 20
Johnson City, TN 37604-8215
Phone
(423) 328-5119
Fax
(423) 328-1138
NPI assigned
Jan 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 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 Primary

Addresses

Primary practice location

509 N State of Franklin Rd Ste 20
Johnson City, TN 37604-8215

Mailing address

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

Other names 1

  • Publix Pharmacy 1633 Doing business as

Medicare participation

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

Enrollment records 2

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…
O20210707003939 TN DME Supplier - Pharmacy 5597765776 Practice locations: Johnson City, TN

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 Tennessee, LLC509 N State of Franklin Rd, Johnson City, TN 37604-8215(423) 328-5119 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

National Provider Directory

National Provider Directory
Tax ID family
Publix Pharmacy 011963 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

Member of 1

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

Locations

509 N State of Franklin Rd
Ste 20
Johnson City, TN 37604
Phone (423) 328-5119

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781568000000",
    "number": "1497345573",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N STATE OF FRANKLIN RD STE 20",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048215",
            "telephone_number": "423-328-5119",
            "fax_number": "423-328-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIX TENNESSEE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-22",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "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 1633",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Publix Pharmacy 1633",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.