Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

PUBLIX SUPER MARKETS INC
NPI 1083654552
Pharmacy - Community/Retail Pharmacy in Fayetteville, GA

Q: What is Publix Super Markets Inc's NPI number?

The NPI number for Publix Super Markets Inc is 1083654552. It was assigned to this organization in the NPPES registry on June 6, 2006. The provider is doing business as Publix Pharmacy #0579.

Q: What is Publix Super Markets Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Active since June 06, 2006

108 PAVILION PKWY, FAYETTEVILLE, GA 30214(770) 460-4106(770) 716-0674 Get Directions Write a Review

NPPES record last updated: June 29, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 3, 2020, Nov 18, 2019 (2 updates tracked since 2019).

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About Publix Super Markets Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PUBLIX SUPER MARKETS INC (NPI 1083654552), doing business as Publix Pharmacy #0579, is a healthcare organization registered as a community/retail pharmacy in Fayetteville, Georgia and active in the NPI registry since June 2006. The organization lists Catherine E Scanlon, Vp Of Pharmacy, as its authorized official.

NPPES Registry Identity

NPI1083654552

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NamePUBLIX SUPER MARKETS INC

Location Address108 PAVILION PKWYFayetteville, GA 30214-4056

Mailing AddressPo Box 639680Cincinnati, OH 45263-9680 · (863) 688-1188 · Fax (863) 616-5846

Phone(770) 460-4106

Fax(770) 716-0674

Organization SubpartNo

Authorized OfficialCatherine E ScanlonVp Of Pharmacy · (863) 688-1188

Enumeration DateJune 6, 2006

Last NPPES UpdateJune 29, 20262 updates tracked since enumeration

NPPES CertifiedJune 29, 2026

✔ NPI 1083654552 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in GA · PHRE008019

Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X

Also ListedPharmacyTaxonomy 333600000X

108 PAVILION PKWY, Fayetteville, GA 30214

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Other Names 1

Doing Business AsPublix Pharmacy #0579

Other Identifiers 2

Other2019562Pk

Medicaid00717967AGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

115 services114 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

103 services103 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Publix Pharmacy 0579 carries, from the Medicare DMEPOS supplier directory.

Publix Pharmacy 0579

DMEPOS supplier · Fayetteville, GAOperated by Publix Super Markets, Inc

✔

Accepts Medicare assignment

Publix Pharmacy 0579 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20474687

Medicare Participant SinceDecember 7, 2016

Supplier Location108 Pavilion PkwyFayetteville, GA 30214

Phone(770) 460-4106

Supplier Specialties

Pharmacy Grocery Store

Medicare Product Categories

Epoetin

Epoetin is a man-made version of human erythropoietin (EPO)

Immunosuppressive Drugs

Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant

Infusion Drugs

Nebulizer Drugs

Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect

Oral Anticancer Drugs

FDA anticancer drugs

Oral Antiemetic Drugs

FDA antiemetic drugs

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SANDRA LAI QUACH PHARM.D.

Pharmacist