Organization Active NPI

Publix North Carolina, LP

Doing business as Publix Pharmacy #1652

  • Community/Retail Pharmacy
  • Raleigh, NC
National Provider Identifier
1619516978
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PUBLIX NORTH CAROLINA, LP
Doing business as
Publix Pharmacy #1652
Practice address
417 W Peace St Ste 100
Raleigh, NC 27603-5017
Phone
(919) 334-2000
Fax
(919) 436-3162
NPI assigned
Jan 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 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

417 W Peace St Ste 100
Raleigh, NC 27603-5017

Mailing address

PO Box 639680
Cincinnati, OH 45263-9680

Other names 1

  • Publix Pharmacy #1652 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20141103001228 TX Part B Supplier - Centralized Flu Biller 8123241858 This NPI is an additional NPI on the enrollment
Practice locations: Charlotte, NC
O20200914000739 NC DME Supplier - Pharmacy 8123241858 Practice locations: Raleigh, NC

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2190459Publix Pharmacy #1652417 W Peace St, Suite 100, Raleigh, NC 27603Certificate of waiverAug 12, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Publix North Carolina, LP417 W Peace St, Raleigh, NC 27603-5017(919) 334-2000 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jan 1, 2015

National Provider Directory

National Provider Directory
Tax ID family
Publix North Carolina LP84 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

417 W Peace St
Ste 100
Raleigh, NC 27603
Phone (919) 334-2000

NPI Registry JSON

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

{
    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782864000000",
    "number": "1619516978",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 W PEACE ST STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276035017",
            "telephone_number": "919-334-2000",
            "fax_number": "919-436-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIX NORTH CAROLINA, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-03",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "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 #1652",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Publix Pharmacy #1652",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.