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General NPI Number Information
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NPI Number | 1972084044
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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 | 08/27/2018
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 1925 WOODWINDS DR STE N1-055
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City | WOODBURY
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State | MN
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Zip | 55125-4445
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Country | US
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Telephone | 651-683-7010
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Fax |
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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 | 612-672-7601
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Fax | 612-884-3592
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Authorized Official
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Title or Position | SYSTEM EXECUTIVE HME O&P
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Name | JILL MARIE MCCARTNEY
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Credential |
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Telephone | 651-632-9835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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