Organization
GRX HOLDINGS LLC
Active
Other names
Medicap Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL FULLER (PRESIDENT)
(515) 321-7644
Entity
Organization
Contact information
Practice address
10 S WARRIOR LANE, WAUKEE, IA 50263-5026
(515) 987-8111
(515) 987-8128
Mailing address
10 S WARRIOR LANE, WAUKEE, IA 50263-9593
(515) 987-8111
(515) 987-8128
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
IA
3336C0003X
Community/Retail Pharmacy
Primary
1103
IA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1620194
NCPDP #
IA
Enumeration date
06/23/2006
Last updated
12/17/2024
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