Organization
ST. MARY'S MEDICAL CENTER
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health St. Mary's Hospice & Palliative Care
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
407 E 4TH ST, DULUTH, MN 55805-2282
(218) 786-4020
(218) 786-4223
Mailing address
407 E 4TH ST, DULUTH, MN 55805-2282
(218) 786-4020
(218) 786-4223
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
02562
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225089634
—
MN
05
—
1225089634
—
WI
01
—
5025446
MEDICA
MN
01
—
7L61ST
BLUE CROSS BLUE SHIELD
MN
Enumeration date
05/12/2006
Last updated
02/28/2024
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