MEDICARE: FAIRVIEW CLINICS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center
2	261QP2300X	Primary Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326230293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAIRVIEW CLINICS

Provider Business Mailing Address
First Line	:	1700 UNIVERSITY AVE W
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-3727
Country	:	US
Telephone Number	:	612-672-6740
Fax Number	:	612-884-3592

Provider Business Practice Location Address
First Line	:	2270 FORD PKWY STE 200
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-3412
Country	:	US
Telephone Number	:	651-696-5000
Fax Number	:	651-696-5001

Authorized Official
Title or Position	:	SYS DIR GOVT REIMB & NETWK REL
Name	:	MAUREEN V RING
Credential	:
Telephone Number	:	612-672-6740

Provider Enumeration Date	:	08/15/2007
Last Update Date	:	02/27/2025

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Directions to “FAIRVIEW CLINICS ” Practice Location

Language	Start Address	Practice Location

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