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Organization
THE DULUTH CLINIC, LTD
Active
Organization
THE DULUTH CLINIC, LTD
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health Superior Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
ESSENTIA HEALTH
Authorized official
KEVIN BOREN (VP OF FINANCE)
(218) 786-1009
Entity
Organization
Contact information
Practice address
3500 TOWER AVE, SUITE A, SUPERIOR, WI 54880-5335
(715) 817-7880
(715) 395-3178
Mailing address
3500 TOWER AVE, SUITE A, SUPERIOR, WI 54880-5335
(715) 817-7880
(715) 395-3178
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
7837
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2777758400
—
MN
05
—
33072400
—
WI
01
—
51-18662
NCPDP
MN
01
—
573
THE DULUTH CLINIC, LTD CHAIN CODE
MN
Enumeration date
08/21/2006
Last updated
02/29/2024
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