Organization · Type 2 NPI

Publix Super Markets Inc

Community/Retail Pharmacy · Kennesaw, GA

NPI number 1174563647 Active

Practice location

4430 Wade Green Rd NW
Kennesaw, GA 30144-1267

Call (770) 419-4036 Map

Fax (770) 792-8362

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	PHRE007669 (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 …

7 other providers at this address

Other community/retail pharmacy providers in Kennesaw

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NPI record

NPI: 1174563647
Entity type: Organization (Type 2)
Issued: Jun 6, 2006
Last updated: Jul 7, 2026
Status: Active

Other names

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Publix Pharmacy #0146 · doing business as
Publix Pharmacy #0146 · 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 1174563647

Publix Super Markets Inc's National Provider Identifier is 1174563647, issued on Jun 6, 2006. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Kennesaw, GA. The record was last updated on Jul 7, 2026.