# THE DULUTH CLINIC, LTD.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ESSENTIA HEALTH
- **Other names:** Essentia Health Prescription Service Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1063881399
- **Legal business name:** ESSENTIA HEALTH
- **Authorized official:** KEVIN BOREN (VP OF FINANCE)
- **Authorized official phone:** (218) 786-1009

## Contact information

- **Practice address:** 204 BELKNAP ST STE 300, SUPERIOR, WI 54880-2905
- **Practice address phone:** (715) 817-7146
- **Practice address fax:** (715) 817-7144
- **Mailing address:** 204 BELKNAP ST STE 300, SUPERIOR, WI 54880-2905
- **Mailing address phone:** (715) 817-7146
- **Mailing address fax:** (715) 817-7144

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 265074 | MN | — |
| 3336C0003X | Community/Retail Pharmacy | 400-1721 | SD | — |
| 3336C0003X | Community/Retail Pharmacy | 46322MS | ID | — |
| 3336C0003X | Community/Retail Pharmacy | 4787 | IA | — |
| 3336C0003X | Community/Retail Pharmacy | 9349-42 | WI | Yes |
| 3336C0003X | Community/Retail Pharmacy | NR-51303 | WY | — |
| 3336C0003X | Community/Retail Pharmacy | PH00004437 | NM | — |
| 3336C0003X | Community/Retail Pharmacy | PH30743 | FL | — |
| 3336C0003X | Community/Retail Pharmacy | PHAR1317 | ND | — |
| 3336C0003X | Community/Retail Pharmacy | Y007116 | AZ | — |
| 3336M0002X | Mail Order Pharmacy | 9349-42 | WI | — |

## Other

- **Enumeration date:** 09/16/2015
- **Last updated:** 02/29/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100054637 | — | WI |
| 05 | — | 1063881399 | — | MN |