MEDICARE: PILLPACK LLC

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	:	1790618833
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PILLPACK LLC

Provider Business Mailing Address
First Line	:	5705 CAMPBELLTON FAIRBURN RD STE 100
Second Line	:
City	:	FAIRBURN
State	:	GA
Zip	:	30213-2589
Country	:	US
Telephone Number	:	855-745-5725
Fax Number	:

Provider Business Practice Location Address
First Line	:	5705 CAMPBELLTON FAIRBURN RD STE 100
Second Line	:
City	:	FAIRBURN
State	:	GA
Zip	:	30213-2589
Country	:	US
Telephone Number	:	855-745-5725
Fax Number	:

Authorized Official
Title or Position	:	REGIONAL MANAGER, REGULATORY OPS
Name	:	MARK SMOSNA
Credential	:
Telephone Number	:	317-258-8636

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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Directions to “PILLPACK LLC ” Practice Location

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