Provider Demographics
NPI:1598417875
Name:ESSENTIA HEALTH SURGERY CENTERS-DULUTH LLC
Entity Type:Organization
Organization Name:ESSENTIA HEALTH SURGERY CENTERS-DULUTH LLC
Other - Org Name:ESSENTIA HEALTH SURGERY CENTER-MILLER HILL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-786-2652
Mailing Address - Street 1:1600 MILLER TRUNK HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-5635
Mailing Address - Country:US
Mailing Address - Phone:218-606-9200
Mailing Address - Fax:218-606-9201
Practice Address - Street 1:1600 MILLER TRUNK HWY STE 101
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-5635
Practice Address - Country:US
Practice Address - Phone:218-606-9200
Practice Address - Fax:218-606-9201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical