Provider Demographics
NPI:1700687316
Name:GRX HOLDINGS LLC
Entity type:Organization
Organization Name:GRX HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-321-7644
Mailing Address - Street 1:1300 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50316-2404
Mailing Address - Country:US
Mailing Address - Phone:515-263-1782
Mailing Address - Fax:515-263-8134
Practice Address - Street 1:1300 E 14TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-2404
Practice Address - Country:US
Practice Address - Phone:515-263-1782
Practice Address - Fax:515-263-8134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy