THE DULUTH CLINIC LTD. NPI 1063881399

NPI Information

  • NPI: 1063881399
  • Provider Name: THE DULUTH CLINIC, LTD.
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Doing Business As: ESSENTIA HEALTH PRESCRIPTION SERVICE CENTER
  • Address: 204 BELKNAP ST STE 300
    SUPERIOR, WI
    ZIP 54880
  • Phone: (715) 817-7146

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NPI Details

THE DULUTH CLINIC, LTD. is a community/retail pharmacy pharmacy in Superior, WI. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. THE DULUTH CLINIC, LTD. NPI is 1063881399. The provider is registered as an organization entity type.
The provider Is Doing Business As Essentia Health Prescription Service Center.

The provider's business location address is:

204 BELKNAP ST STE 300
SUPERIOR, WI
ZIP 54880-905
Phone: (715) 817-7146
Fax: (715) 817-7144

The provider's authorized official is Kevin Boren .
The authorized official title is Vp Of Finance and has the following contact phone number (218) 786-1009.

The enumeration date for this NPI number is 9/16/2015 and was last updated on 2/29/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail Pharmacy265074MINNESOTANo
23336C0003XPharmacyCommunity/Retail PharmacyPHAR1317NORTH DAKOTANo
33336C0003XPharmacyCommunity/Retail Pharmacy4787IOWANo
43336C0003XPharmacyCommunity/Retail Pharmacy46322MSIDAHONo
53336C0003XPharmacyCommunity/Retail PharmacyPH00004437NEW MEXICONo
63336C0003XPharmacyCommunity/Retail PharmacyNR-51303WYOMINGNo
73336C0003XPharmacyCommunity/Retail PharmacyY007116ARIZONANo
83336C0003XPharmacyCommunity/Retail PharmacyPH30743FLORIDANo
93336C0003XPharmacyCommunity/Retail Pharmacy400-1721SOUTH DAKOTANo
103336M0002XPharmacyMail Order Pharmacy9349-42WISCONSINNo
113336C0003XPharmacyCommunity/Retail Pharmacy9349-42WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1100054637MEDICAIDWISCONSIN
21063881399MEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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