Organization
RURAL RX LLC
Active
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
Update your record
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