Active NPI
MCLD Corporation
Doing business as West Liberty
- Pharmacy
- West Liberty, IA
National Provider Identifier
1619966405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- MCLD CORPORATION
- Doing business as
- West Liberty
- Practice address
- 105 E 3Rd St
West Liberty, IA 52776-1401 - Phone
- (319) 465-4906
- NPI assigned
- Oct 14, 2005
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | NU | Primary |
Addresses
Primary practice location
105 E 3Rd St
West Liberty, IA 52776-1401
Mailing address
105 E 3Rd St
West Liberty, IA 52776-1401
Phone (319) 627-4317
Other names 1
- West Liberty
National Provider Directory
National Provider Directory- Tax ID family
- MCLD Corporation
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Downtown Drug
- Durable Medical Equipment & Medical Supplies
- Cedar Rapids, IA
- NPI 1093866071
Locations
105 E 3rd St
West Liberty, IA 52776
Phone (319) 465-4906
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129248000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1619966405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 E 3RD ST",
"city": "WEST LIBERTY",
"state": "IA",
"postal_code": "527761401",
"telephone_number": "319-627-4317",
"fax_number": "319-627-2037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 E 3RD ST",
"city": "WEST LIBERTY",
"state": "IA",
"postal_code": "527761401",
"telephone_number": "319-465-4906"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MCLD CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-14",
"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": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "West Liberty",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in West Liberty, 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.