Organization
MCLD CORPORATION
Active
Other names
STRAWBERRY POINT DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER TUETKEN PHARM D (PRES)
(319) 221-1050
Entity
Organization
Contact information
Practice address
104 W MISSION ST, STRAWBERRY POINT, IA 52076
(563) 933-4762
(563) 933-9909
Mailing address
207 2ND AVE SE, STE A, CEDAR RAPIDS, IA 52401-1238
(319) 221-1033
(319) 221-1050
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
68
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1623455
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/25/2008
Last updated
03/22/2010
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