Organization
THE DULUTH CLINIC, LTD.
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health Superior East 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
2202 E 2ND ST., SUITE 477, SUPERIOR, WI 54880-5395
(715) 817-7999
(715) 392-0215
Mailing address
2202 E 2ND ST., SUITE 477, SUPERIOR, WI 54880-5395
(715) 817-7999
(715) 392-0215
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
9247-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100037008
—
WI
01
—
1477979326
NPI
—
05
—
1477979326
—
MN
Enumeration date
03/14/2014
Last updated
02/29/2024
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