NPIMap

Organization Active NPI

Publix Super Markets Inc

  • Community/Retail Pharmacy
  • Jacksonville, FL
National Provider Identifier
1497795835
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH0020775 Issued in FL
Legal business name
PUBLIX SUPER MARKETS INC
Practice address
11406 San Jose Blvd
Jacksonville, FL 32223-7963
Phone
(904) 262-5991
Fax
(904) 262-7584
NPI assigned
Jun 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PH0020775 FL Primary

Addresses

Primary practice location

11406 San Jose Blvd
Jacksonville, FL 32223-7963

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
2008912OtherPK
026927100MedicaidFL

Other names 1

  • Publix Pharmacy #1022 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL2 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
O20100930022107 FL DME Supplier - Pharmacy 4385644673 Practice locations: Jacksonville, FL

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 #102211406 San Jose Blvd, Jacksonville, FL 32223(904) 262-5991 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Dec 7, 2016

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

Locations

11406 San Jose Blvd
Jacksonville, FL 32223
Phone (904) 262-5991

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782345600000",
    "number": "1497795835",
    "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": "11406 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322237963",
            "telephone_number": "904-262-5991",
            "fax_number": "904-262-7584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIX SUPER MARKETS INC",
        "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 OF PHARMACY",
        "authorized_official_telephone_number": "863-688-1188"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH0020775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2008912",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026927100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Publix Pharmacy #1022",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Publix Pharmacy #1022",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

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.