Provider Demographics
NPI:1407928294
Name:NORECAP INC
Entity Type:Organization
Organization Name:NORECAP INC
Other - Org Name:MEDICAP PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHROYER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:563-547-5111
Mailing Address - Street 1:303 2ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:CRESCO
Mailing Address - State:IA
Mailing Address - Zip Code:52136-1843
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:303 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:CRESCO
Practice Address - State:IA
Practice Address - Zip Code:52136-1843
Practice Address - Country:US
Practice Address - Phone:563-547-5111
Practice Address - Fax:563-547-5113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA97333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1614874OtherOTHER ID NUMBER-COMMERCIAL NUMBER
IA0039545Medicaid
IABM0530279OtherDEA #
IA0715530001Medicare NSC