LAKE SUPERIOR COMMUNITY HEALTH CENTER NPI 1568832277

NPI Information

NPI: 1568832277
Provider Name: LAKE SUPERIOR COMMUNITY HEALTH CENTER
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 24D0403966

Address:
4325 GRAND AVE
DULUTH, MN
ZIP 55807
Phone: (218) 722-1497
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LAKE SUPERIOR COMMUNITY HEALTH CENTER is a federally qualified health center (fqhc) clinic center in Duluth, MN. LAKE SUPERIOR COMMUNITY HEALTH CENTER NPI is 1568832277. The provider is registered as an organization entity type.

The provider's business location address is:

4325 GRAND AVE
DULUTH, MN
ZIP 55807-730
Phone: (218) 722-1497
Fax: (218) 727-8346

The provider's authorized official is Katrina Jaworski .
The authorized official title is Director Of Finance and has the following contact phone number (715) 392-1955.

The CLIA number assigned to this NPI record is 24D0403966 - federally qualified health center with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 10/7/2015 and was last updated on 8/26/2020.

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
1	261QP2300X	Clinic/Center	Primary Care	R 228856-1	MINNESOTA	No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

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: 11/14/2023

NPI Synchronization or Removal

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