NPIMap

Organization Active NPI

The Duluth Clinic, LTD

Doing business as Essentia Health Specialty Pharmacy

  • Pharmacy
  • Superior, WI
National Provider Identifier
1316615321
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
THE DULUTH CLINIC, LTD
Doing business as
Essentia Health Specialty Pharmacy
Practice address
204 Belknap St Ste 200
Superior, WI 54880-2905
Phone
(715) 817-7145
Fax
(715) 817-7144
NPI assigned
Sep 3, 2021
Last updated
Sep 22, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. MARY'S DULUTH CLINIC HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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)CodeLicenseStatePrimary
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 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Duluth Clinic-Ely35 organizations share this tax ID, including this one
Part of
St Mary's Duluth Clinic Health System

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

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.

Verify at the official NPI Registry.