# THE DULUTH CLINIC, LTD

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ESSENTIA HEALTH
- **Other names:** Essentia Health Superior Pharmacy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1154437564
- **Legal business name:** ESSENTIA HEALTH
- **Authorized official:** KEVIN BOREN (VP OF FINANCE)
- **Authorized official phone:** (218) 786-1009

## Contact information

- **Practice address:** 3500 TOWER AVE, SUITE A, SUPERIOR, WI 54880-5335
- **Practice address phone:** (715) 817-7880
- **Practice address fax:** (715) 395-3178
- **Mailing address:** 3500 TOWER AVE, SUITE A, SUPERIOR, WI 54880-5335
- **Mailing address phone:** (715) 817-7880
- **Mailing address fax:** (715) 395-3178

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 7837 | WI | Yes |

## Other

- **Enumeration date:** 08/21/2006
- **Last updated:** 02/29/2024

## 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 |