THE DULUTH CLINIC, LTD (NPI# 1154437564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154437564 |
| Entity Type | Organization |
| Organization Name | THE DULUTH CLINIC, LTD |
| Other Organization Name | ESSENTIA HEALTH SUPERIOR PHARMACY |
| Practice Address |
3500 Tower Ave Suite A Superior WI 54880-5335 |
| Practice Telephone | 7158177880 |
| Practice Fax Number | 7153953178 |
| Mailing Telephone | 7158177880 |
| Mailing Fax Number | 7153953178 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2014-12-11 |
| Authorized Official Name | SANDRA H MASTAW (COORDINATOR PHARMACY OPERATIONS) |
| Authorized Official Telephone | 21857864265 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. MARY'S DULUTH CLINIC HEALTH SYSTEM |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
7837 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | THE DULUTH CLINIC, LTD CHAIN CODE | 573 | 01 |
| WI | 33072400 | 05 | |
| MN | 2777758400 | 05 | |
| MN | NCPDP | 51-18662 | 01 |
| Other Name | Type Code |
|---|---|
| Essentia Health Superior Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467750364 | The Duluth Clinic, Ltd | Pharmacy | 802 11th St Ste C, Two Harbors, MN 55616-1413 | 2011-03-02 |
| 1881633238 | The Duluth Clinic, Ltd | Clinic/Center | N10504 Grandview Ln, Ironwood, MI 49938-9621 | 2006-06-04 |
| 1356389316 | The Duluth Clinic, Ltd | Clinic/Center | 400 Nw 1st Street, Chisholm, MN 55719-1706 | 2006-06-03 |
| 1780621508 | The Duluth Clinic, Ltd | Clinic/Center | 730 E 34th St, Hibbing, MN 55746-5109 | 2006-06-01 |
| 1982641791 | The Duluth Clinic, Ltd | Clinic/Center | 405 W 3rd Ave N, Box 392, Aurora, MN 55705-1247 | 2006-06-01 |
| 1235176058 | The Duluth Clinic, Ltd | Clinic/Center | 4855 W Arrowhead Rd, Hermantown, MN 55811-3936 | 2006-06-01 |
| 1538506894 | The Duluth Clinic, Ltd | Clinic/Center | 901 9th St N, Virginia, MN 55792-2325 | 2013-05-28 |
| 1003114539 | The Duluth Clinic, Ltd | Pharmacy | 1502 London Rd, Suite 101, Duluth, MN 55812-1788 | 2011-03-08 |
| 1437457330 | The Duluth Clinic, Ltd | Pharmacy | 99 Edison Blvd, Suite L, Silver Bay, MN 55614-1211 | 2011-03-02 |
| 1902103831 | The Duluth Clinic, Ltd | Clinic/Center | 211 S Boundary Ave, Proctor, MN 55810-2306 | 2011-02-11 |
| Street Address |
3500 TOWER AVE SUITE A |
| City | SUPERIOR |
| State | WI |
| Zip Code | 54880-5335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801872080 | Vicki Brady | Nurse Practitioner | 3500 Tower Ave, Superior, WI 54880-5335 | 2005-12-19 |
| 1659911014 | Mary K Robinson | Social Worker | 3500 Tower Ave, Superior, WI 54880-4491 | 2020-01-13 |
| 1265093413 | Paige Lois Slemmons | Physical Therapist | 3500 Tower Ave, Superior, WI 54880-4491 | 2019-06-27 |
| 1164994513 | Elaina A Fischer | Nurse Practitioner | 3500 Tower Ave, Superior, WI 54880-4491 | 2018-12-26 |
| 1992229579 | Renee Christine Karth-pearson | Social Worker | 3500 Tower Ave, Superior, WI 54880-4491 | 2017-07-26 |
| 1821518267 | Ryan Morgan | Family Medicine | 3500 Tower Ave, Superior, WI 54880-4491 | 2017-06-27 |
| 1639699200 | Nicholas C. Ellefson | Family Medicine | 3500 Tower Ave, Superior, WI 54880-4491 | 2017-06-23 |
| 1760837819 | Eric James Estes | Physical Therapist | 3500 Tower Ave, Superior, WI 54880-4491 | 2016-04-26 |
| 1710352018 | Christina Drexler | Occupational Therapist | 3500 Tower Ave, Superior, WI 54880-5395 | 2015-12-11 |
| 1063881399 | The Duluth Clinic, Ltd. | Pharmacy | 3500 Tower Ave, Suite C, Superior, WI 54880-4685 | 2015-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427194 | Alana Catherine Sullivan | Speech-Language Pathologist | 25 N 25th Street E, Superior, WI 54880 | 2020-11-05 |
| 1710524970 | Sean Wiberg Peterson | Specialist/Technologist | 1810 Catlin Ave, Room 1246, Superior, WI 54880 | 2019-12-06 |
| 1558858936 | Brent Adam Engstrom | Student in an Organized Health Care Education/Training Program | 1410 Nth 23rd Street, Superior, WI 54880 | 2018-04-20 |
| 1558769125 | David Kroll | Specialist | Balknap & Catlin Aves., Superior, WI 54880 | 2014-12-15 |
| 1154670321 | Superior Treatment Center, Inc | Community/Behavioral Health | 1507 Tower Ave Ste 307, Superior, WI 54880 | 2012-09-04 |
| 1548551658 | Dionne Jeannine Corcoran | Midwife | 916 Hammond Ave Ste 222, Superior, WI 54880 | 2011-04-22 |
| 1821235433 | Lauren Ashley Miller | Speech-Language Pathologist | 35 N. 28th Street, Superior, WI 54880 | 2009-01-20 |
| 1528261989 | Stacy Ann Kennelly | Physical Therapist | 1612 N 37th Street, Superior, WI 54880 | 2007-06-06 |
| 1760564942 | James Henry Dobis | Family Medicine | 3520 Tower Avenue, Twin Ports Va Outpatient Clinic, Superior, WI 54880 | 2006-10-19 |
| 1134214398 | Kevin M Mikel | Dentist | 3312 Tower Avenue, Superior, WI 54880 | 2006-10-04 |
| Find all providers in zip 54880 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942816939 | The Duluth Clinic, Ltd. | Pharmacy | 204 Belknap St, Ste 100, Superior, WI 54880-2964 | 2020-09-16 |
| 1477979326 | The Duluth Clinic, Ltd. | Pharmacy | 2202 E 2nd St., Suite 477, Superior, WI 54880-5395 | 2014-03-14 |
| 1811084023 | Superior Pharmacy, Inc. | Pharmacy | 348 N Central Ave, Superior, NE 68978-1715 | 2006-10-07 |
| 1063881399 | The Duluth Clinic, Ltd. | Pharmacy | 3500 Tower Ave, Suite C, Superior, WI 54880-4685 | 2015-09-16 |
| 1871962282 | The Duluth Clinic, Ltd. | Pharmacy | 3500 Tower Ave, Suite B, Superior, WI 54880-4685 | 2015-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902417207 | Ipack Pharmacy LLC | Pharmacy | 17000 W North Ave Ste 108w, Brookfield, WI 53005-4423 | 2020-08-11 |
| 1851939037 | Ascension Wisconsin Pharmacy, Inc | Pharmacy | 10180 Washington Ave Ste 102, Mount Pleasant, WI 53177-1604 | 2019-12-18 |
| 1558906354 | Life Change Rx 4 LLC | Pharmacy | 6300 N 76th St Ste 246, Milwaukee, WI 53218-1208 | 2019-11-15 |
| 1285278978 | Life Change Rx 3 LLC | Pharmacy | 7115 W Capitol Dr, Milwaukee, WI 53216-2051 | 2019-11-05 |
| 1295377703 | Hayat Pharmacy 21 LLC. | Pharmacy | 2333 Northwestern Ave Ste 120, Racine, WI 53404-2520 | 2019-10-16 |
| 1487296737 | Xperience Pharmacy LLC | Pharmacy | 5715 W Appleton Ave, Milwaukee, WI 53210-2250 | 2019-10-08 |
| 1962053421 | Hayat Pharmacy 19 LLC | Pharmacy | 805 W. Layton Ave. Suite A, Milwaukee, WI 53221 | 2019-09-26 |
| 1275182925 | Walgreen Co | Pharmacy | 2265 N Mayfair Rd, Wauwatosa, WI 53226-2207 | 2019-09-05 |
| 1982257200 | Hayat Pharmacy 16 LLC | Pharmacy | 603 N 36th St, Milwaukee, WI 53208-3826 | 2019-07-17 |
| 1407408420 | Hayat Pharmacy 18 LLC | Pharmacy | 140 E Water St Ste 3, West Bend, WI 53095-3415 | 2019-07-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.