NPIMap

Organization Active NPI

GRX Holdings LLC

  • Community/Retail Pharmacy
  • Ames, IA
National Provider Identifier
1669408175
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
123 Issued in IA
Legal business name
GRX HOLDINGS LLC
Practice address
105 Lincoln Way
Ames, IA 50010-3323
Phone
(515) 232-1563
Fax
(515) 232-3382
NPI assigned
Jun 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X 123 IA Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

105 Lincoln Way
Ames, IA 50010-3323

Mailing address

105 Lincoln Way
Ames, IA 50010-3323
Phone (515) 232-1563

Other identifiers 1

IdentifierTypeStateIssuer
1607867OtherIANCPDP #

Other names 1

  • Medicap Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

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…
O20100930033119 IA DME Supplier - Pharmacy 9931278744 Practice locations: Ames, IA

Other NPIs with the same Medicare PAC ID 19

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

View all 19

Other NPIs on the same Medicare enrollment 19

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

View all 19

National Provider Directory

National Provider Directory
Tax ID family
GRX Holdings LLC49 organizations share this tax ID, including this one

Other organizations with this 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.

Locations

105 Lincoln Way
Ames, IA 50010
Phone (515) 232-1563

Ownership & related parties

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 AcresUrbandale, IA, CCN 165460 Skilled nursing facility Adp of the SNF Aug 1, 2018

Owned or controlled facilities with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1669408175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 LINCOLN WAY",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500103323",
            "telephone_number": "515-232-1563",
            "fax_number": "515-232-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 LINCOLN WAY",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500103323",
            "telephone_number": "515-232-1563",
            "fax_number": "515-232-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRX HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-321-7644"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "123",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP #",
            "identifier": "1607867",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicap Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medicap Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ames, IA

Sources for this page

Verify at the official NPI Registry.