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Organization

THE DULUTH CLINIC, LTD

Active
Parent organization
ST.. MARY'S DULUTH CLINIC HEALTH SYSTEM
Other names
Essentia Health Hayward Pharmacy
Organization subpart
Yes

Provider details

NPI number
Legal business name
ST.. MARY'S DULUTH CLINIC HEALTH SYSTEM
Authorized official
KEVIN BOREN (VP OF FINANCE)
(218) 786-1009
Entity
Organization

Contact information

Practice address
11134 N STATE ROAD 77 STE A, HAYWARD, WI 54843-5325
(715) 634-6774
(715) 634-5517
Mailing address
11134 N STATE ROAD 77 STE A, HAYWARD, WI 54843-5325
(715) 634-6774
(715) 634-5517

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
7772
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33232000
WI
05
448819900
WI
01
51-24401
NCPDP
MN
01
573
THE DULUTH CLINIC, LTD CHAIN CODE
MN
Enumeration date
08/20/2006
Last updated
02/12/2025
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