Organization
RURAL RX LLC
Active
Other names
Medicap Pharmacy, Greene County Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA YOUNGBLOOD PHARM. D. (OWNER/PIC)
(515) 386-2164
Entity
Organization
Contact information
Practice address
400 N ELM ST, JEFFERSON, IA 50129
(515) 386-2164
(515) 386-8521
Mailing address
400 N ELM ST, JEFFERSON, IA 50129-1420
(515) 386-2164
(515) 386-8521
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
IA
333600000X
Pharmacy
623
IA
3336C0003X
Community/Retail Pharmacy
Primary
—
IA
3336L0003X
Long Term Care Pharmacy
623
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0216986
—
IA
01
—
1611652
NCPDP #
IA
Enumeration date
06/08/2005
Last updated
04/08/2025
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