Healthcare Provider Details

I. General information

NPI: 1093679318
Provider Name (Legal Business Name): GRX HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 STORY ST
BOONE IA
50036-3533
US

IV. Provider business mailing address

403 STORY ST
BOONE IA
50036-3533
US

V. Phone/Fax

Practice location:
  • Phone: 515-432-2311
  • Fax: 515-432-8562
Mailing address:
  • Phone: 515-432-2311
  • Fax: 515-432-8562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL FULLER
Title or Position: PRESIDENT
Credential:
Phone: 515-321-7644