THE DULUTH CLINIC, LTD (NPI# 1831204940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831204940 |
| Entity Type | Organization |
| Organization Name | THE DULUTH CLINIC, LTD |
| Other Organization Name | ESSENTIA HEALTH LAKESIDE PHARMACY |
| Practice Address |
4621 E Superior St Suite A Duluth MN 55804-2338 |
| Practice Telephone | 2187863784 |
| Practice Fax Number | 2185257338 |
| Mailing Telephone | 2187863784 |
| Mailing Fax Number | 2185257338 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2014-12-11 |
| Authorized Official Name | SANDRA H MASTAW (COORDINATOR PHARMACY OPERATIONS) |
| Authorized Official Telephone | 2187864265 |
| Authorized Official Credential | MT. BA |
| 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 |
2612425 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 106358800 | 05 | |
| WI | 33163300 | 05 | |
| MN | THE DULUTH CLINIC, LTD CHAIN CODE | 573 | 01 |
| MN | NCPDP | 24-04642 | 01 |
| Other Name | Type Code |
|---|---|
| Essentia Health Lakeside 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 |
4621 E SUPERIOR ST SUITE A |
| City | DULUTH |
| State | MN |
| Zip Code | 55804-2338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104886977 | Sarah Adeen Ziring | Physical Therapist | 4621 E Superior St, Duluth, MN 55804 | 2006-03-24 |
| 1861031759 | Daniel F Kuevi Akoe | Nurse Practitioner | 4621 E Superior St, Duluth, MN 55804-2338 | 2019-12-26 |
| 1730521717 | Molly C Backstrom | Nurse Practitioner | 4621 E Superior St, Essentia Health Lakeside Clinic, Duluth, MN 55804-2338 | 2013-07-19 |
| 1932276623 | Penny Lynn Bennett | Physical Therapist | 4621 E Superior St, Duluth, MN 55804-2338 | 2006-11-29 |
| 1548351406 | Ingrid Louisa Nisswandt-larsen | Family Medicine | 4621 E Superior St, Duluth, MN 55804-2338 | 2006-09-27 |
| 1043319726 | Molly Herzan Burton | Physical Therapist | 4621 E Superior St, Duluth, MN 55804-2338 | 2006-09-21 |
| 1518971118 | Erik J Sather | Family Medicine | 4621 E Superior St, Duluth, MN 55804 | 2006-07-28 |
| 1023034105 | Steven Peter Phillipson | Family Medicine | 4621 E Superior St, Duluth, MN 55804-2338 | 2006-07-14 |
| 1962428730 | Angela L. Reichart | Physician Assistant | 4621 E Superior St, Duluth, MN 55804-2338 | 2006-07-14 |
| 1205852076 | Hugh Patrick Renier | Family Medicine | 4621 E Superior St, Duluth, MN 55804-2338 | 2006-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235593591 | Michelle Leblanc | Speech-Language Pathologist | 5017 London Rd., Duluth, MN 55804 | 2016-04-12 |
| 1346541075 | Christina Finlo | Marriage & Family Therapist | 4849 Ivanhoe St, Duluth, MN 55804 | 2010-11-11 |
| 1821301623 | Rachel Gabrielle Ashford | Social Worker | 5107 E Superior St, Duluth, MN 55804 | 2010-07-21 |
| 1932381423 | Janet Florence Lewis | Registered Nurse | 4231 Dodge Street, Duluth, MN 55804 | 2007-11-27 |
| 1245419894 | Ernest Carl Hansen | Physical Therapist | 4002 London Rd., Duluth, MN 55804 | 2007-10-31 |
| 1316011596 | Melissa J. Janzen | Chiropractor | 4731 E Superior St, Duluth, MN 55804 | 2006-11-20 |
| 1861406522 | Susan Klee Anderson | Family Medicine | 4621 E Superior St., Duluth, MN 55804 | 2006-07-28 |
| 1285831040 | Janzen Chiropractic Pa | Chiropractor | 4731 E Superior St, Duluth, MN 55804 | 2007-06-27 |
| 1912121708 | Cooley Chiropractic Clinic, Inc. | Chiropractor | 5722 Homestead Rd, Duluth, MN 55804 | 2007-04-12 |
| 1831663343 | Jennifer T Rennquist | Counselor | 5223 Glendale St, Duluth, MN 55804-1110 | 2019-01-17 |
| Find all providers in zip 55804 | ||||
| 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 |
| Find all providers in DULUTH | ||||
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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.