MCLD Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

583 Issued in IA

Legal business name

MCLD CORPORATION

Doing business as

Star Drug

Practice address

517 Court St
Williamsburg, IA 52361

Phone

(319) 668-1520

Fax

(319) 668-8178

NPI assigned

Nov 28, 2006

Last updated

Aug 13, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christopher Tuetken, PHARM DNPI 1649445552

Title

Owner

Phone

(319) 221-1050

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• STAR DRUG Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christopher P Tuetken, PHARMD, RPH

  • Pharmacist
  • Cedar Rapids, IA
  • NPI 1649445552
  Authorized official Same address or phone
• Elisha Andreas

  • Pharmacist
  • Williamsburg, IA
  • NPI 1205450616
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407888000000",
    "number": "1003982315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 2ND ST SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524011405",
            "telephone_number": "319-221-1050",
            "fax_number": "319-221-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 COURT ST",
            "city": "WILLIAMSBURG",
            "state": "IA",
            "postal_code": "52361",
            "telephone_number": "319-668-1520",
            "fax_number": "319-668-8178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLD CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2014-08-13",
        "status": "A",
        "authorized_official_last_name": "TUETKEN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-221-1050",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2026820",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0021725",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STAR DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Haedrich Maas, RD, LD, MDA
• Marengo Memorial Hospital (Williamsburg Family Medical Clinic)
• Robert Marlin, DDS
• Brian Marovets, M.D.
• Cami Marshall
• MCLD Corporation (Star Drug)
• Midwest Counseling, LLC
• Annalee Rose Moody
• Jacob Riley Mauricio Nelson, D.C
• Gregory P Neyman, M.D.

• Community/Retail Pharmacy in Williamsburg, IA
• Providers in Williamsburg, IA by specialty
• Community/Retail Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.