NPIMap

GRX Holdings LLC

Organization Active NPI Community/Retail Pharmacy · Indianola, IA

NPI 1093764086 · NPPES record last updated Sep 11, 2025

Key facts

NPI
1093764086
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
495 (IA)
Legal business name
GRX HOLDINGS LLC
Practice address
2105 N 3Rd LN
Indianola, IA 50125
Phone
(515) 961-5303
Fax
(515) 961-5964
NPI assigned
May 8, 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.

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…
O20100930062479 IA DME Supplier - Pharmacy 9931278744 Practice locations: Indianola, IA

National Provider Directory

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

Locations

208 E Euclid Ave
Indianola, IA 50125
Phone (515) 961-5303

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X 495 IA Yes
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

2105 N 3Rd LN
Indianola, IA 50125

Mailing address

2105 N 3Rd LN
Indianola, IA 50125
Phone (515) 961-5303

Other identifiers

IdentifierTypeStateIssuer
1613606OtherIANCPDP #

Other names

  • Medicap Pharmacy Doing business as

Other providers in Indianola, IA

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

Sources for this page

Verify at the official NPI Registry.