NPIMap

GRX Holdings LLC

Organization Active NPI Community/Retail Pharmacy · Waukee, IA

NPI 1023044179 · NPPES record last updated Dec 17, 2024

Key facts

NPI
1023044179
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
1103 (IA)
Legal business name
GRX HOLDINGS LLC
Practice address
10 S Warrior Lane
Waukee, IA 50263-5026
Phone
(515) 987-8111
Fax
(515) 987-8128
NPI assigned
Jun 23, 2006
Organization subpart
No

Authorized official

Name
Michael Fuller
Title
President
Phone
(515) 321-7644

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 48

Organizations that report the same tax identification number in the National Provider Directory.

View all 48

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D0975636Medicap Pharmacy #8256
10 Warrior Lane, Waukee, IA 50263		Certificate of waiverJul 11, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Medicap Pharmacy
10 S Warrior LN, Waukee, IA 50263-9593 · (515) 987-8111		 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Seat Lift Mechanisms|Walkers|Orthoses: … Does not accept assignment
Participating since May 1, 2008

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in IA

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Karen Acres
Urbandale, IA · CCN 165460		 Skilled nursing facility Adp of the SNF Aug 1, 2018

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080520000539 IA Part B Supplier - Mass Immunization (Roster Biller Only) 9931278744 21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winterset, IA; Waukee, IA; Stuart, IA; Panora, IA; Boone, IA; Norwalk, IA; Newton, IA; Knoxville, IA…
O20100930041899 IA DME Supplier - Pharmacy 9931278744 Practice locations: Waukee, IA

National Provider Directory

Tax ID family
GRX Holdings LLC (49 organizations share this tax ID)

Locations

10 S Warrior Ln
Waukee, IA 50263
Phone (515) 987-8111

105 N Warrior Ln
Waukee, IA 50263
Phone (515) 987-8111

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X IA
Community/Retail Pharmacy 3336C0003X 1103 IA Yes
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

10 S Warrior Lane
Waukee, IA 50263-5026

Mailing address

10 S Warrior Lane
Waukee, IA 50263-9593
Phone (515) 987-8111

Other identifiers

IdentifierTypeStateIssuer
1620194OtherIANCPDP #

Other names

  • Medicap Pharmacy Doing business as

Other providers in Waukee, IA

All providers in Waukee, IA · Community/Retail Pharmacy in Iowa

Sources for this page

Verify at the official NPI Registry.