MEDICARE: RJGRX INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	385	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2027500	OTHER		PK

General Provider Information

NPI Number	:	1124192539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RJGRX INC

Provider Business Mailing Address
First Line	:	PO BOX 120
Second Line	:
City	:	DENVER
State	:	IA
Zip	:	50622-0120
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	340 S STATE ST
Second Line	:
City	:	DENVER
State	:	IA
Zip	:	50622-7706
Country	:	US
Telephone Number	:	319-984-5691
Fax Number	:	319-984-5687

Authorized Official
Title or Position	:	OWNER
Name	:	ROBERT GREENWOOD
Credential	:	RPH
Telephone Number	:	319-234-6673

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	10/22/2021

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Directions to “RJGRX INC ” Practice Location

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