Healthcare Provider Details

I. General information

NPI: 1598677718
Provider Name (Legal Business Name): FAIRVIEW HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 FULTON ST SE FL 5
MINNEAPOLIS MN
55455-4800
US

IV. Provider business mailing address

1700 UNIVERSITY AVE W
SAINT PAUL MN
55104-3727
US

V. Phone/Fax

Practice location:
  • Phone: 612-273-8383
  • Fax:
Mailing address:
  • Phone: 612-672-6740
  • Fax: 612-884-3592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MAUREEN VERONICA-REGER RING
Title or Position: SYS DIR GOVT REIMB & NETWK REL
Credential:
Phone: 612-672-6740