# ST. MARY'S HOSPITAL OF SUPERIOR

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ESSENTIA HEALTH
- **Other names:** Essentia Health St. Mary's-Superior Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1588691588
- **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, SUPERIOR, WI 54880-5335
- **Practice address phone:** (715) 817-7100
- **Practice address fax:** (715) 395-5433
- **Mailing address:** 3500 TOWER AVE, SUPERIOR, WI 54880-5335
- **Mailing address phone:** (715) 817-7100
- **Mailing address fax:** (715) 395-5433

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC0050X | Critical Access Hospital Clinic/Center | 5516-800 | WI | Yes |

## Other

- **Enumeration date:** 06/26/2006
- **Last updated:** 02/28/2024