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General NPI Number Information
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NPI Number | 1245217520
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Entity Type | Organization
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Legal Business Name | FAIRVIEW HEALTH SERVICES
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 201 E NICOLLET BLVD
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City | BURNSVILLE
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State | MN
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Zip | 55337-5714
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Country | US
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Telephone | 952-892-2000
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Fax | 952-892-2107
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Provider Business Mailing Address
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Address Line | 1700 UNIVERSITY AVE W
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City | SAINT PAUL
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State | MN
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Zip | 55104-3727
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Country | US
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Telephone | 612-672-6740
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Fax | 612-884-3592
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Authorized Official
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Title or Position | SYS DIR GOVT REIMB & NETWK REL
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Name | MAUREEN V RING
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Credential |
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Telephone | 612-672-6740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 00107
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License Number State | MN
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