Clear Stream LTC, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

2007013239 Issued in MO

Legal business name

CLEAR STREAM LTC, LLC

Doing business as

Clear Stream LTC

Practice address

2210 Barron Rd Ste B-012
Poplar Bluff, MO 63901-1908

Phone

(573) 686-4556

Fax

(573) 686-4529

NPI assigned

Jun 13, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Mark Taylor Kleinbeck, RPH

Title

President

Phone

(573) 686-4556

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Clear Stream LTC Doing business as

Tax ID family

Clear Stream LTC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Clear Stream LTC, LLC

  • Long Term Care Pharmacy
  • Poplar Bluff, MO
  • NPI 1659575983
  NPD tax ID

Locations

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1548464415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 BARRON RD STE B-012",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011908",
            "telephone_number": "573-686-4556",
            "fax_number": "573-686-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 BARRON RD STE B-012",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011908",
            "telephone_number": "573-686-4556",
            "fax_number": "573-686-4529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR STREAM LTC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "KLEINBECK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-686-4556",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": "2007013239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIN",
            "identifier": "K90FQ0Y00",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY PERMIT",
            "identifier": "2007013239",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clear Stream LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carol Morris Clark, PHARM. D
• Donna Renee Clark
• Dorthy Carlene Clark, RN
• Kristian Clark
• Stephanie Clark, NP
• Clear Stream LTC, LLC
• Montanna Clemons
• Cleous Chiropractic LLC
• Katelyn Brooke Cleous, PMHNP
• Ryan Cleous, DC

• Durable Medical Equipment & Medical Supplies in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Durable Medical Equipment & Medical Supplies in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.