Organization
ST. MARY'S HOSPITAL OF SUPERIOR
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health St. Mary's Hospital Superior
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, SUPERIOR, WI 54880-5335
(715) 395-5400
Mailing address
3500 TOWER AVE, SUPERIOR, WI 54880-5335
(715) 395-5400
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
1032
WI
282NC0060X
Critical Access Hospital
Primary
5516-800
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083657886
—
WI
Enumeration date
06/13/2006
Last updated
02/28/2024
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