Active NPI
The Duluth Clinic, LTD
- Pharmacy
- Superior, WI
National Provider Identifier
1316615321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- THE DULUTH CLINIC, LTD
- Practice address
- 204 Belknap St Ste 200
Superior, WI 54880-2905 - Phone
- (715) 817-7145
- Fax
- (715) 817-7144
- NPI assigned
- Sep 3, 2021
- Organization subpart
- Yes
- Parent organization
- ST. MARY'S DULUTH CLINIC HEALTH SYSTEM
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bradley Beard
- Title
- Coo
- Phone
- (218) 786-5652
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | Primary | ||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
204 Belknap St Ste 200
Superior, WI 54880-2905
Mailing address
204 Belknap St Ste 200
Superior, WI 54880-2905
Phone (715) 817-7145
Other names 1
- Essentia Health Specialty Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Duluth Clinic LTD Wi
- Part of
- St Marys Duluth Clinic Health System
Other organizations with this tax ID 34
Organizations that report the same tax identification number in the National Provider Directory.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Superior, WI
- NPI 1083889554
-
- Community/Retail Pharmacy
- Superior, WI
- NPI 1154437564
-
- Community/Retail Pharmacy
- Hayward, WI
- NPI 1386759496
-
- Multi-Specialty Clinic/Center
- Superior, WI
- NPI 1427110824
-
- Community/Retail Pharmacy
- Superior, WI
- NPI 1063881399
-
- Community/Retail Pharmacy
- Superior, WI
- NPI 1477979326
-
- Specialty Pharmacy
- Superior, WI
- NPI 1871962282
-
- Medical Specialty Clinic/Center
- Virginia, MN
- NPI 1326028150
-
- Home Health Agency
- Duluth, MN
- NPI 1043245921
-
- Multi-Specialty Clinic/Center
- Duluth, MN
- NPI 1245855162
-
- Community/Retail Pharmacy
- Duluth, MN
- NPI 1427164839
-
- Rehabilitation Clinic/Center
- Duluth, MN
- NPI 1730028770
Locations
204 Belknap St
Ste 200
Superior, WI 54880
Phone (715) 817-7145
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630627200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1632268800000",
"number": "1316615321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 BELKNAP ST STE 200",
"city": "SUPERIOR",
"state": "WI",
"postal_code": "548802905",
"telephone_number": "715-817-7145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 BELKNAP ST STE 200",
"city": "SUPERIOR",
"state": "WI",
"postal_code": "548802905",
"telephone_number": "715-817-7145",
"fax_number": "715-817-7144"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE DULUTH CLINIC, LTD",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ST. MARY'S DULUTH CLINIC HEALTH SYSTEM",
"enumeration_date": "2021-09-03",
"last_updated": "2021-09-22",
"certification_date": "2021-09-22",
"status": "A",
"authorized_official_last_name": "BEARD",
"authorized_official_first_name": "BRADLEY",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "218-786-5652"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Essentia Health Specialty Pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Essentia Health Specialty Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Superior, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.