Provider Demographics
NPI:1689278145
Name:PILLPACK LLC
Entity Type:Organization
Organization Name:PILLPACK LLC
Other - Org Name:AMAZON PHARMACY #006
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:LAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-745-5725
Mailing Address - Street 1:3620 PLAINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46231
Mailing Address - Country:US
Mailing Address - Phone:855-745-5725
Mailing Address - Fax:603-935-9108
Practice Address - Street 1:3620 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46231
Practice Address - Country:US
Practice Address - Phone:855-745-5725
Practice Address - Fax:603-935-9108
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PILLPACK LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-25
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy