MEDICARE: PACK RX INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy

General Provider Information

NPI Number	:	1326918244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACK RX INC.

Provider Business Mailing Address
First Line	:	461 MONROE TPKE
Second Line	:
City	:	MONROE
State	:	CT
Zip	:	06468-2338
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	461 MONROE TPKE
Second Line	:
City	:	MONROE
State	:	CT
Zip	:	06468-2338
Country	:	US
Telephone Number	:	904-314-2276
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NAGA VENKATA JAKKA
Credential	:
Telephone Number	:	904-314-2276

Provider Enumeration Date	:	11/06/2025
Last Update Date	:	12/30/2025

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Directions to “PACK RX INC. ” Practice Location

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