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
615 E MAIN ST, PANORA, IA 50216-1097
(641) 755-2312
(641) 755-3773
Mailing address
615 E MAIN ST, PANORA, IA 50216-1097
(641) 755-2312
(641) 755-3773
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1491
IA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Enumeration date
12/18/2013
Last updated
12/17/2024
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