Organization
THE DULUTH CLINIC, LTD
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health Virginia 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
1101 9TH ST N, SUITE A, VIRGINIA, MN 55792-2329
(218) 749-7828
(218) 749-7962
Mailing address
1101 9TH ST N, SUITE A, VIRGINIA, MN 55792-2329
(218) 749-7828
(218) 749-7962
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2045144
MN
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194812100
—
MN
01
—
24-22688
NCPDP
MN
01
—
573
THE DULUTH CLINIC, LTD CHAIN CODE
MN
Enumeration date
08/20/2006
Last updated
07/03/2024
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