MEDICARE: GRX HOLDINGS LLC

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	3336L0003X	Long Term Care Pharmacy
3	3336C0003X	Community/Retail Pharmacy	425	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1619569	OTHER	IA	NCPDP #

General Provider Information

NPI Number	:	1912956020
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRX HOLDINGS LLC

Provider Business Mailing Address
First Line	:	800 SCHOOL ST
Second Line	:
City	:	CARLISLE
State	:	IA
Zip	:	50047-9716
Country	:	US
Telephone Number	:	515-989-3261
Fax Number	:	515-989-4140

Provider Business Practice Location Address
First Line	:	800 SCHOOL ST
Second Line	:
City	:	CARLISLE
State	:	IA
Zip	:	50047-9716
Country	:	US
Telephone Number	:	515-989-3261
Fax Number	:	515-989-4140

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL FULLER
Credential	:
Telephone Number	:	515-321-7644

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	12/17/2024

Similar Medicare Providers

1790282333 — MRS. PAMELA TRASK GOODE PHARMD
Practice Location Address:

800 SCHOOL ST
CARLISLE, IA
50047-9716

Practice Phone: 515-989-3261
Practice Fax: 515-989-4140

1619525367 — KRISTIN STOPULOS
Practice Location Address:

800 SCHOOL ST
CARLISLE, IA
50047-9716

Practice Phone: 515-989-3261
Practice Fax:

1205821444 — DR. JENNIFER MAE OLSON DO
Practice Location Address:

2755 S. GATEWAY DRIVE
CARLISLE, IA
50047-2301

Practice Phone: 515-358-7300
Practice Fax: 515-358-7341

1407841653 — DR. MICHAEL J MCCORMICK DO
Practice Location Address:

125 SCHOOL ST , PO BOX F
CARLISLE, IA
50047-8702

Practice Phone: 515-989-3221
Practice Fax: 515-989-4518

1114912813 — FAMILY PRACTICE CLINIC PLC
Practice Location Address:

125 SCHOOL ST
CARLISLE, IA
50047-8702

Practice Phone: 515-989-3221
Practice Fax: 515-989-4518

1417937699 — MARY E MALCOM DO
Practice Location Address:

45 COLUMBIA ST
CARLISLE, IA
50047-7715

Practice Phone: 515-989-4143
Practice Fax:

Directions to “GRX HOLDINGS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.