Organization
MCLD CORPORATION
Active
Other names
Downtown Drug
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER PHILLIP TUETKEN PHARMD, RPH (PRESIDENT)
(319) 465-4906
Entity
Organization
Contact information
Practice address
207 2ND AVENUE SE STE A, CEDAR RAPIDS, IA 52403
(319) 221-1050
(319) 221-1053
Mailing address
207 2ND AVE SE, STE A, CEDAR RAPIDS, IA 52401-1238
(319) 221-1050
(319) 221-1053
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1281
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0480913
—
IA
Enumeration date
01/16/2007
Last updated
04/23/2008
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