ST. MARY'S HOSPITAL OF SUPERIOR NPI 1588691588

NPI Information

  • NPI: 1588691588
  • Provider Name: ST. MARY'S HOSPITAL OF SUPERIOR
  • Classification: Clinic/Center - 261QC0050X
  • Specialization: Critical Access Hospital
  • Entity Type: Organization
  • Doing Business As: ESSENTIA HEALTH ST. MARY'S-SUPERIOR CLINIC
  • Address: 3500 TOWER AVE
    SUPERIOR, WI
    ZIP 54880
  • Phone: (715) 817-7100

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NPI Details

ST. MARY'S HOSPITAL OF SUPERIOR is a critical access hospital clinic center in Superior, WI. The provider is an outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary care services for individuals in a small rural community and is Medicare certified. ST. MARY'S HOSPITAL OF SUPERIOR NPI is 1588691588. The provider is registered as an organization entity type.
The provider Is Doing Business As Essentia Health St. Mary's-superior Clinic.

The provider's business location address is:

3500 TOWER AVE
SUPERIOR, WI
ZIP 54880-335
Phone: (715) 817-7100
Fax: (715) 395-5433

The provider's authorized official is Kevin Boren .
The authorized official title is Vp Of Finance and has the following contact phone number (218) 786-1009.

The enumeration date for this NPI number is 6/26/2006 and was last updated on 2/28/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QC0050XClinic/CenterCritical Access Hospital5516-800WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11588691588MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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