CLEAR STREAM LTC, LLC (NPI# 1659575983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659575983 |
| Entity Type | Organization |
| Organization Name | CLEAR STREAM LTC, LLC |
| Other Organization Name | CLEAR STREAM LTC |
| Practice Address |
2210 Barron Rd Ste B-012 Poplar Bluff MO 63901-1908 |
| Practice Telephone | 5736864556 |
| Practice Fax Number | 5736864529 |
| Mailing Telephone | 5736864556 |
| Mailing Fax Number | 5736864529 |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MARK TAYLOR KLEINBECK (PRESIDENT) |
| Authorized Official Telephone | 5736864556 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
2007013239 | MO | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HIN | K90FQ0Y00 | 01 | |
| MO | PHARMACY PERMIT | 2007013239 | 01 |
| MO | DEA | FC0291179 | 01 |
| Other Name | Type Code |
|---|---|
| Clear Stream LTC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548464415 | Clear Stream Ltc, LLC | Durable Medical Equipment & Medical Supplies | 2210 Barron Rd Ste B-012, Poplar Bluff, MO 63901-1908 | 2007-06-13 |
| Street Address |
2210 BARRON RD STE B-012 |
| City | POPLAR BLUFF |
| State | MO |
| Zip Code | 63901-1908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548464415 | Clear Stream Ltc, LLC | Durable Medical Equipment & Medical Supplies | 2210 Barron Rd Ste B-012, Poplar Bluff, MO 63901-1908 | 2007-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076701 | Alternative Sleep Solution | Dentist | 2700 Kanell Blvd., Poplar Bluff, MO 63901 | 2020-09-04 |
| 1285271239 | Front Door Wellness LLC | Physical Therapist | Front Door Wellness LLC, 5835 Quail Meadows Drive, Poplar Bluff, MO 63901 | 2019-12-09 |
| 1104470368 | Andrew Akindutire | Dentist | 3101 Oak Groove Rd., Suite 6, Poplar Bluff, MO 63901 | 2019-07-26 |
| 1780195966 | Midwest Equipment Srv Systems LLC | Technician, Pathology | 2400 Lucy Lee Parkway, Suite C, Poplar Bluff, MO 63901 | 2017-10-16 |
| 1801259387 | Richard Justin Huber | Technician, Other | 3005 Warrior Ln, Poplar Bluff, MO 63901 | 2016-04-01 |
| 1699136275 | Donja Kirkland | Recreation Therapist | 1910a Greenwood Dr., Suite D, Poplar Bluff, MO 63901 | 2016-03-10 |
| 1760866867 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 3050 Tucker Road, Poplar Bluff, MO 63901 | 2015-07-17 |
| 1407246390 | Lisa Marie Payne | Physical Therapist | 4358c Highway Pp, Poplar Bluff, MO 63901 | 2015-01-29 |
| 1700202488 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1602 W. Harper Street, Poplar Bluff, MO 63901 | 2014-03-05 |
| 1932521648 | Essential Family Healthcare, LLC | Clinic/Center | 1369 North Westwood Blvd., Poplar Bluff, MO 63901 | 2014-01-15 |
| Find all providers in zip 63901 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750421079 | East Side Pharmacy Inc | Pharmacy | 400 East Pine Blvd., Poplar Bluff, MO 63901 | 2007-02-07 |
| 1972557171 | Eastside Discount Pharmacy | Pharmacy | 400 E Pine St, Poplar Bluff, MO 63901-5401 | 2006-05-20 |
| 1780830455 | Physician Park Investment Company | Pharmacy | 225 Physicians Park, Ste 100a, Poplar Bluff, MO 63901-3956 | 2008-08-14 |
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| 1023620838 | Tipton Pharmacy | Pharmacy | 310 Us Highway 50 W, Tipton, MO 65081-8701 | 2020-08-21 |
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| 1053953109 | Summers Pharmacy of Slater, LLC | Pharmacy | 102 E Maple St, Slater, MO 65349-1539 | 2019-10-10 |
| 1316594328 | Legacy Drugstore LLC | Pharmacy | 13000 Veterans Memorial Pkwy Ste A, Wright City, MO 63390-1012 | 2019-08-23 |
| 1972158673 | Hils Pharmacy Salisbury LLC | Pharmacy | 501 E. 24 Hwy Ste A, Salisbury, MO 65281 | 2019-08-08 |
| 1700342888 | Battlefield Pharmacy | Pharmacy | 4062 W Republic Rd, Battlefield, MO 65619-7108 | 2019-02-14 |
| 1548733769 | Guardian Pharmacy of St. Louis, LLC | Pharmacy | 926 S Highway Dr, Fenton, MO 63026-2023 | 2019-01-10 |
| Find all providers with the same taxonomy | ||||
| City | POPLAR BLUFF |
| Zip Code | 63901 |
Please comment or provide details below to improve the information on CLEAR STREAM LTC, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.