NPIMap

Organization Active NPI

MCLD Corporation

  • Durable Medical Equipment & Medical Supplies
  • Cedar Rapids, IA
National Provider Identifier
1093866071
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
1281 Issued in IA
Legal business name
MCLD CORPORATION
Practice address
207 2ND Avenue SE Ste a
Cedar Rapids, IA 52403
Phone
(319) 221-1050
Fax
(319) 221-1053
NPI assigned
Jan 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Authorized official

Name
Christopher Phillip Tuetken, PHARMD, RPH
Title
President
Phone
(319) 465-4906

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 1281 IA Primary

Addresses

Primary practice location

207 2ND Avenue SE Ste a
Cedar Rapids, IA 52403

Mailing address

207 2ND Ave SE
Ste a
Cedar Rapids, IA 52401-1238
Phone (319) 221-1050

Other identifiers 1

IdentifierTypeStateIssuer
0480913MedicaidIA

Other names 1

  • Downtown Drug 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": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1093866071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 2ND AVE SE",
            "address_2": "STE A",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524011238",
            "telephone_number": "319-221-1050",
            "fax_number": "319-221-1053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 2ND AVENUE SE STE A",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52403",
            "telephone_number": "319-221-1050",
            "fax_number": "319-221-1053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLD CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "TUETKEN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-465-4906",
        "authorized_official_credential": "PHARMD, RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IA",
            "license": "1281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0480913",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Downtown Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.