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NPI 1841315165

NPI 1841315165 : FAIRVIEW CLINICS : MAPLE GROVE, MN

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General NPI Number Information
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    NPI Number           |    1841315165
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    Entity Type          |    Organization 
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    Legal Business Name  |    FAIRVIEW CLINICS 
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Dates
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    Enumeration Date     |    03/20/2007
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    Last Update Date     |    02/28/2025
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Provider Practice Location Address
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    Address Line         |    14500 99TH AVE N STE 100
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    City                 |    MAPLE GROVE
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    State                |    MN
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    Zip                  |    55369-4478
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    Country              |    US
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    Telephone            |    763-898-1000
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    Fax                  |    763-898-1009
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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        |    261QM1300X
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    Taxonomy Name        |    Multi-Specialty Clinic/Center
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    License Number       |    
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    License Number State |    
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