THE DULUTH CLINIC LTD (NPI# 1427164839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427164839 |
| Entity Type | Organization |
| Organization Name | THE DULUTH CLINIC LTD |
| Other Organization Name | ESSENTIA HEALTH WEST DULUTH PHARMACY |
| Practice Address |
4212 Grand Ave Suite A Duluth MN 55807-2737 |
| Practice Telephone | 2187863700 |
| Practice Fax Number | 2187863705 |
| Mailing Telephone | 2187863700 |
| Mailing Fax Number | 2187863705 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2014-12-11 |
| Authorized Official Name | SANDRA H MASTAW (COORDINATOR PHARMACY OPERATIONS) |
| Authorized Official Telephone | 2187864265 |
| 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 |
261243 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 210558600 | 05 | |
| WI | 33050700 | 05 | |
| MN | THE DULUTH CLINIC, LTD CHAIN CODE | 573 | 01 |
| MN | NCPDP | 24-16572 | 01 |
| Other Name | Type Code |
|---|---|
| Essentia Health West Duluth Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245855162 | The Duluth Clinic Ltd | Clinic/Center | 1600 Miller Trunk Hwy Ste 1300, Duluth, MN 55811-5640 | 2020-06-16 |
| 1902459209 | The Duluth Clinic Ltd | Clinic/Center | 1301 Miller Trunk Hwy Ste 400, Duluth, MN 55811-5639 | 2019-07-17 |
| 1003478892 | The Duluth Clinic Ltd | Clinic/Center | 4289 Ugstad Rd, Hermantown, MN 55811-3615 | 2019-07-02 |
| 1831690346 | The Duluth Clinic Ltd | Pharmacy | 1542 Golf Course Rd Ste 205, Grand Rapids, MN 55744-3555 | 2018-02-21 |
| 1184132664 | The Duluth Clinic Ltd | Clinic/Center | 1542 Golf Course Rd Ste 204, Grand Rapids, MN 55744-3555 | 2018-01-18 |
| Street Address |
4212 GRAND AVE SUITE A |
| City | DULUTH |
| State | MN |
| Zip Code | 55807-2737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205882594 | Adam Charles Swank | Family Medicine | 4212 Grand Ave, Essentia Health West Duluth Clinic, Duluth, MN 55807-2737 | 2006-05-26 |
| 1134743586 | Erika K Ehlers | Registered Nurse | 4212 Grand Ave, Duluth, MN 55807-2737 | 2020-06-02 |
| 1457991804 | Matt Kleven | Physician Assistant | 4212 Grand Ave, Duluth, MN 55807-2737 | 2020-01-14 |
| 1588204044 | Matthew G Schull | Physician Assistant | 4212 Grand Ave, Duluth, MN 55807-2737 | 2020-01-13 |
| 1124675566 | Amos Restad | Nurse Practitioner | 4212 Grand Ave, Duluth, MN 55807-2737 | 2019-08-21 |
| 1164089702 | Sarah M Jackson | Physical Therapist | 4212 Grand Ave, Duluth, MN 55807-2737 | 2019-05-20 |
| 1023578515 | Megan Elizabeth Markes | Physician Assistant | 4212 Grand Ave, Duluth, MN 55807-2737 | 2019-03-21 |
| 1134685035 | Anthony C Guidone | Nurse Practitioner | 4212 Grand Ave, Duluth, MN 55807-2737 | 2019-02-15 |
| 1679051791 | Brianna N Buske | Physical Therapist | 4212 Grand Ave, Duluth, MN 55807-2737 | 2018-07-31 |
| 1174075246 | Lucette Vankessel | Nurse Practitioner | 4212 Grand Ave, Essentia Health West Duluth Clinic, Duluth, MN 55807-2737 | 2016-10-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568918126 | Jaime Lynn Mallory | Counselor | 4000 W 9th St., Duluth, MN 55807 | 2016-09-01 |
| 1568817138 | Fathers Rise Together | Community/Behavioral Health | 319 N 22nd Ave West, Duluth, MN 55807 | 2016-05-02 |
| 1558660357 | Melissa June Huray | Counselor | 326 North Central Avenue, Duluth, MN 55807 | 2011-03-18 |
| 1376757682 | Chiropractic Health Center P A | Chiropractor | 215 North Central Ave, Duluth, MN 55807 | 2007-05-09 |
| 1639235914 | Mark Andrew Nelson Albee | Social Worker | 4214 Grand Avenue, Duluth Clinic-west, Duluth, MN 55807 | 2006-12-29 |
| 1851457758 | Northwood Children's Services, Inc. | Counselor | 4000 W 9th St, Duluth, MN 55807 | 2006-12-28 |
| 1679934012 | Rebecca Ann Peterson | Nurse Practitioner | 4325 Grand Ave, Duluth, MN 55807 | 2016-03-13 |
| 1225525645 | Mark J Engebretson | Social Worker | 5814 Elinor St, Duluth, MN 55807-1215 | 2018-04-20 |
| 1235756784 | Allissa Rardin | Social Worker | 720 N Central Ave, Duluth, MN 55807-1305 | 2020-07-01 |
| 1588898829 | Angela Sue Rosas | Registered Nurse | 618 1/2 N 56th Ave W, Duluth, MN 55807-1325 | 2009-05-14 |
| Find all providers in zip 55807 | ||||
| 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 |
|---|---|---|---|---|
| 1043782998 | Anchor Plus Rx, LLC | Pharmacy | 3800 Pleasant Hill Rd Ste 2, Duluth, GA 30096-1428 | 2018-12-17 |
| 1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
| 1073917449 | Suju Enterprise Inc | Pharmacy | 4195 Pleasant Hill Rd.suite D, Duluth, GA 30096 | 2014-10-14 |
| 1285050823 | Duluth Pharmacy LLC | Pharmacy | 3890 Pleasant Hill Rd Ste 103, Duluth, GA 30096-4807 | 2014-03-06 |
| 1326383498 | Corner Pharmacy Inc | Pharmacy | 2550 Pleasant Hill Rd Ste 120, Duluth, GA 30096-9278 | 2012-11-30 |
| 1265627681 | Falks Woodland Pharmacy Inc | Pharmacy | 1600 Woodland Ave, Duluth, MN 55803-2628 | 2007-09-10 |
| 1063627271 | Prescription Specialties | Pharmacy | 1601 London Rd, Duluth, MN 55812-1620 | 2007-05-11 |
| 1205978996 | Bingamite | Pharmacy | 113 N 2nd Ave W, Duluth, MN 55802-1911 | 2007-02-12 |
| 1215019005 | Duluth Rexall Pharmacy Inc | Pharmacy | 3165 Buford Hwy, Duluth, GA 30096-3351 | 2006-10-20 |
| 1982707733 | Georgia Cvs Pharmacy LLC | Pharmacy | 4110 Pleasant Hill Rd, Duluth, GA 30096-4853 | 2006-09-07 |
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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.