Provider Demographics
NPI:1821438862
Name:PILLPACK LLC
Entity Type:Organization
Organization Name:PILLPACK LLC
Other - Org Name:PILLPACK BY AMAZON PHARMACY
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 1:250 COMMERCIAL ST
Mailing Address - Street 2:SUITE 2012
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1142
Mailing Address - Country:US
Mailing Address - Phone:855-745-5725
Mailing Address - Fax:
Practice Address - Street 1:250 COMMERCIAL ST
Practice Address - Street 2:SUITE 2012
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1142
Practice Address - Country:US
Practice Address - Phone:855-745-5725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-03
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH07963336C0003X, 3336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy