Organization
THE DULUTH CLINIC, LTD.
Active
Parent organization
ESSENTIA HEALTH
Other names
Essentia Health Specialty 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
204 BELKNAP ST STE 200, SUPERIOR, WI 54880-2905
(715) 817-7145
(715) 817-7144
Mailing address
204 BELKNAP ST STE 200, SUPERIOR, WI 54880-2905
(715) 817-7145
(715) 817-7144
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
265022
MN
3336C0003X
Community/Retail Pharmacy
400-1673
SD
3336C0003X
Community/Retail Pharmacy
4788
IA
3336C0003X
Community/Retail Pharmacy
9348-42
WI
3336C0003X
Community/Retail Pharmacy
PHAR1337
ND
3336S0011X
Specialty Pharmacy
Primary
9348-42
WI
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100051572
—
WI
05
—
1871962282
—
MN
Enumeration date
09/16/2015
Last updated
02/29/2024
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