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
318 N LINCOLN ST, KNOXVILLE, IA 50138-2714
(641) 828-7312
(641) 828-6303
Mailing address
2929 WESTOWN PKWY STE 100, WEST DES MOINES, IA 50266-1319
(515) 440-1270
(515) 222-2658
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
758
IA
3336L0003X
Long Term Care Pharmacy
758
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1613896
NCPDP #
IA
Enumeration date
05/03/2006
Last updated
11/07/2025
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