NPI Code Details Logo

NPI 1851583637

NPI 1851583637 : FAIRVIEW CLINICS : LAKEVILLE, MN

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1851583637
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    FAIRVIEW CLINICS 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    08/15/2007
-----------------------------------------------------
    Last Update Date     |    02/28/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    18580 JOPLIN AVE 
-----------------------------------------------------
    City                 |    LAKEVILLE
-----------------------------------------------------
    State                |    MN
-----------------------------------------------------
    Zip                  |    55044-4218
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    952-892-9555
-----------------------------------------------------
    Fax                  |    952-892-9505
-----------------------------------------------------

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

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

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QP2300X
-----------------------------------------------------
    Taxonomy Name        |    Primary Care Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    261QU0200X
-----------------------------------------------------
    Taxonomy Name        |    Urgent Care Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.