Healthcare Provider Details

I. General information

NPI: 1326918244
Provider Name (Legal Business Name): PACK RX INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 MONROE TPKE
MONROE CT
06468-2338
US

IV. Provider business mailing address

461 MONROE TPKE
MONROE CT
06468-2338
US

V. Phone/Fax

Practice location:
  • Phone: 904-314-2276
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: NAGA VENKATA JAKKA
Title or Position: PRESIDENT
Credential:
Phone: 904-314-2276