RURAL RX LLC NPI 1639173685

NPI Information

  • NPI: 1639173685
  • Provider Name: RURAL RX LLC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • :
  • CLIA Number: 16D2290019
  • Address: 400 N ELM ST
    JEFFERSON, IA
    ZIP 50129
  • Phone: (515) 386-2164

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NPI Details

RURAL RX LLC is a community/retail pharmacy pharmacy in Jefferson, IA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. RURAL RX LLC NPI is 1639173685. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

400 N ELM ST
JEFFERSON, IA
ZIP 50129
Phone: (515) 386-2164
Fax: (515) 386-8521

The provider's authorized official is Samantha Youngblood .
The authorized official title is Owner/pic and has the following contact phone number (515) 386-2164.

The CLIA number assigned to this NPI record is 16D2290019 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Fee covid-19 vac 14 res (HCPCS:0134A)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Adm sarscov2 50 mcg/.5 mlbst (HCPCS:0094A)
  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)

The enumeration date for this NPI number is 6/8/2005 and was last updated on 4/8/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesIOWANo
2333600000XPharmacy623IOWANo
33336C0003XPharmacyCommunity/Retail PharmacyIOWAYes
43336L0003XPharmacyLong Term Care Pharmacy623IOWANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10216986MEDICAIDIOWA
21611652OTHERIOWANCPDP #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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