Organization Active NPI

MCLD Corporation

Doing business as Village Pharmacy - Victor

  • Pharmacy
  • Victor, IA
National Provider Identifier
1073501938
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
MCLD CORPORATION
Doing business as
Village Pharmacy - Victor
Practice address
205 Washington St
Victor, IA 52347
Phone
(319) 647-3322
Fax
(319) 647-2382
NPI assigned
Oct 13, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Christopher Phillip Tuetken
Title
Pharmacist / Owner
Phone
(319) 465-4906

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

205 Washington St
Victor, IA 52347

Mailing address

205 Washington St
Victor, IA 52347
Phone (319) 647-3322

Other names 1

  • Village Pharmacy - Victor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
MCLD Corporation5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073501938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 WASHINGTON ST",
            "city": "VICTOR",
            "state": "IA",
            "postal_code": "52347",
            "telephone_number": "319-647-3322",
            "fax_number": "319-647-2382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 WASHINGTON ST",
            "city": "VICTOR",
            "state": "IA",
            "postal_code": "52347",
            "telephone_number": "319-647-3322",
            "fax_number": "319-647-2382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLD CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TUETKEN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "PHARMACIST / OWNER",
        "authorized_official_telephone_number": "319-465-4906",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Pharmacy - Victor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Victor, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.