Organization
THE DULUTH CLINIC, LTD
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health Silver Bay 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
99 EDISON BLVD, SUITE L, SILVER BAY, MN 55614-1211
(218) 226-3829
(218) 226-3860
Mailing address
99 EDISON BLVD, SUITE L, SILVER BAY, MN 55614-1211
(218) 226-3829
(218) 226-3860
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
263668
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437457330
—
MN
01
—
24-30700
NCPDP
MN
01
—
573
THE DULUTH CLINIC, LTD. CHAIN CODE
MN
Enumeration date
03/02/2011
Last updated
02/29/2024
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