Provider Demographics
NPI:1982471728
Name:PILLPACK LLC
Entity Type:Organization
Organization Name:PILLPACK LLC
Other - Org Name:AMAZON PHARMACY #010
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 1:1331 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-1750
Mailing Address - Country:US
Mailing Address - Phone:855-745-5725
Mailing Address - Fax:
Practice Address - Street 1:1331 E 6TH ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-1750
Practice Address - Country:US
Practice Address - Phone:855-745-5725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PILLPACK LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-11
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy