Organization
ST. MARY'S HOSPITAL OF SUPERIOR
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health St. Mary's-Superior Clinic
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
3500 TOWER AVE, SUPERIOR, WI 54880-5335
(715) 817-7100
(715) 395-5433
Mailing address
3500 TOWER AVE, SUPERIOR, WI 54880-5335
(715) 817-7100
(715) 395-5433
Taxonomy
Speciality
Code
Description
License number
State
261QC0050X
Critical Access Hospital Clinic/Center
Primary
5516-800
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588691588
—
WI
Enumeration date
06/26/2006
Last updated
02/28/2024
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