Healthcare Provider Details

I. General information

NPI: 1508702622
Provider Name (Legal Business Name): PILLPACK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5705 HIGHWAY 92 STE 100
FAIRBURN GA
30213-2589
US

IV. Provider business mailing address

5705 HIGHWAY 92 STE 100
FAIRBURN GA
30213-2589
US

V. Phone/Fax

Practice location:
  • Phone: 855-745-5725
  • Fax:
Mailing address:
  • Phone: 855-745-5725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARK SMOSNA
Title or Position: REGIONAL MANAGER, REGULATORY OPS
Credential:
Phone: 317-258-8636