Organization
ST. MARY'S DULUTH CLINIC HEALTH SYSTEM
Active
Parent organization
ST. MARY'S DULUTH CLINIC HEALTH SYSTEM
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. MARY'S DULUTH CLINIC HEALTH SYSTEM
Authorized official
KEVIN BOREN (CFO)
(218) 786-1009
Entity
Organization
Contact information
Practice address
3500 TOWER AVE, SUPERIOR, WI 54880-5335
(715) 817-7520
Mailing address
3500 TOWER AVE, SUPERIOR, WI 54880-5335
(715) 817-7520
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
52D0040190
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205866928
—
MN
05
—
1205866928
—
WI
05
—
424630316
—
MI
Enumeration date
07/05/2006
Last updated
12/28/2017
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