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Organization

THE DULUTH CLINIC, LTD

Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health Lakewalk 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
1502 LONDON RD, SUITE 101, DULUTH, MN 55812-1788
(218) 733-1110
(218) 733-1112
Mailing address
1502 LONDON RD, SUITE 101, DULUTH, MN 55812-1788
(218) 786-3563

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
263667
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1003114539
MN
01
2430712
NCPDP
MN
01
573
THE DULUTH CLINIC, LTD. CHAIN CODE
MN
Enumeration date
03/08/2011
Last updated
02/28/2024
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