# THE DULUTH CLINIC, LTD

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST.. MARY'S DULUTH CLINIC HEALTH SYSTEM
- **Other names:** Essentia Health Hayward Pharmacy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1386759496
- **Legal business name:** ST.. MARY'S DULUTH CLINIC HEALTH SYSTEM
- **Authorized official:** KEVIN BOREN (VP OF FINANCE)
- **Authorized official phone:** (218) 786-1009

## Contact information

- **Practice address:** 11134 N STATE ROAD 77 STE A, HAYWARD, WI 54843-5325
- **Practice address phone:** (715) 634-6774
- **Practice address fax:** (715) 634-5517
- **Mailing address:** 11134 N STATE ROAD 77 STE A, HAYWARD, WI 54843-5325
- **Mailing address phone:** (715) 634-6774
- **Mailing address fax:** (715) 634-5517

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 7772 | WI | Yes |

## Other

- **Enumeration date:** 08/20/2006
- **Last updated:** 02/12/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 33232000 | — | WI |
| 05 | — | 448819900 | — | WI |
| 01 | — | 51-24401 | NCPDP | MN |
| 01 | — | 573 | THE DULUTH CLINIC, LTD CHAIN CODE | MN |