Provider Information for 1245081066
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THE DULUTH CLINIC, LTD.
Other Names:Doing Business As:ESSENTIA HEALTH HINCKLEY PHARMACYOrganization Subpart: YES
NPI: 1245081066
Last Updated: 2024-04-15
Certification Date: 2024-04-15
Certification Date: 2024-04-15
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1245081066 | ||||||||
| Enumeration Date | 2024-03-29 | ||||||||
| NPI Type | NPI-2 Organization | ||||||||
| Status | Active | ||||||||
| Authorized Official Information | Name: KEVIN BOREN Title: VP of Finance Phone: 2187861009 | ||||||||
| Mailing Address | 45 LADY LUCK DR STE 110 HINCKLEY, MN 55037-6419 United States Phone: 320-279-8610 | Fax: | ||||||||
| Primary Practice Address | 45 LADY LUCK DR STE 110 HINCKLEY, MN 55037-6419 United States Phone: 320-279-8610 | Fax: | ||||||||
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