NPIMap

Organization Active NPI

Reliant Care Pharmacy Services LLC

Doing business as Trio Pharmacy Services

  • Long Term Care Pharmacy
  • Coralville, IA
National Provider Identifier
1487977195
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
1373 Issued in IA
Legal business name
RELIANT CARE PHARMACY SERVICES LLC
Doing business as
Trio Pharmacy Services
Practice address
4105 Westcor CT Ste 1
Coralville, IA 52241-2874
Phone
(319) 545-5100
Fax
(319) 545-5103
NPI assigned
Mar 9, 2010
Last updated
Dec 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Devin R Rujawitz
Title
Billing Manager
Phone
(314) 597-1809

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 1373 IA Primary

Addresses

Primary practice location

4105 Westcor CT Ste 1
Coralville, IA 52241-2874

Mailing address

4105 Westcor CT Ste 1
Coralville, IA 52241-2874
Phone (319) 545-5100

Other identifiers 3

IdentifierTypeStateIssuer
0102901MedicaidIA
100258954MedicaidNE
2124590OtherPK

Other names 1

  • Trio Pharmacy Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230130001318 IA Part B Supplier - Mass Immunization (Roster Biller Only) 2466823406 Practice locations: Coralville, IA

National Provider Directory

National Provider Directory

Locations

4105 Westcor Ct
Ste 1
Coralville, IA 52241
Phone (319) 545-5100

Ownership & related parties

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Western Home CommunitiesCedar Falls, IA, CCN 165508 Skilled nursing facility Adp of the SNF Feb 28, 2023
Parkview Manor Care CenterReinbeck, IA, CCN 165522 Skilled nursing facility Adp of the SNF Feb 28, 2023
Madrid Home for the AgingMadrid, IA, CCN 165118 Skilled nursing facility Adp of the SNF Feb 28, 2023
Bishop Drumm Retirement CenterJohnston, IA, CCN 165448 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 1, 2024
Jul 10, 2025
CreeksideGrundy Center, IA, CCN 165623 Skilled nursing facility Adp of the SNF Feb 28, 2023
The Suites at Western Home CommunitiesCedar Falls, IA, CCN 165622 Skilled nursing facility Adp of the SNF Feb 28, 2023

Owned or controlled facilities with NPI records 6

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671062400000",
    "number": "1487977195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 WESTCOR CT STE 1",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412874",
            "telephone_number": "319-545-5100",
            "fax_number": "319-545-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 WESTCOR CT STE 1",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412874",
            "telephone_number": "319-545-5100",
            "fax_number": "319-545-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIANT CARE PHARMACY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-09",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "RUJAWITZ",
        "authorized_official_first_name": "DEVIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "314-597-1809"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IA",
            "license": "1373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0102901",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100258954",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2124590",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trio Pharmacy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coralville, IA

Sources for this page

Verify at the official NPI Registry.