Organization · Type 2 NPI

Publix Super Markets Inc

Community/Retail Pharmacy · Fayetteville, GA

NPI number 1083654552 Active

Practice location

108 Pavilion Pkwy
Fayetteville, GA 30214-4056

Call (770) 460-4106 Map

Fax (770) 716-0674

Mailing address

PO Box 639680
Cincinnati, OH 45263-9680

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	PHRE008019 (GA)

Community/Retail Pharmacy: 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 …

8 other providers at this address

Other community/retail pharmacy providers in Fayetteville

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NPI record

NPI: 1083654552
Entity type: Organization (Type 2)
Issued: Jun 6, 2006
Last updated: Jun 29, 2026
Status: Active

Other names

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Publix Pharmacy #0579 · doing business as
Publix Pharmacy #0579 · doing business as

Authorized official

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

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1083654552

Publix Super Markets Inc's National Provider Identifier is 1083654552, issued on Jun 6, 2006. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Fayetteville, GA. The record was last updated on Jun 29, 2026.