MEDICARE: FAIRVIEW HEALTH SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician
2	367500000X	Certified Registered Nurse Anesthetist
3	282N00000X	General Acute Care Hospital	00408	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3943740	OTHER	MN	MEDICA
2	76895	OTHER	MN	PREFERREDONE
3	20103813	OTHER	MN	MHP
4	24560FA	OTHER	MN	BCBS
5	5002017	OTHER	MN	MEDICA
6	1006066	OTHER	MN	PREFERREDONE
7	5002	OTHER	MN	PREFERREDONE
8	9840014	OTHER	MN	MEDICA
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	140046	OTHER	MN	UCARE
11	1814HFA	OTHER	MN	BCBS
12	8866	OTHER	MN	HEALTHPARTNERS
13	15F16VA	OTHER	MN	BCBS
14	27581	OTHER	MN	HEALTHPARTNERS
15	980226003	OTHER	MN	MHP
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922085299
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAIRVIEW HEALTH SERVICES

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

Provider Business Practice Location Address
First Line	:	911 NORTHLAND DR
Second Line	:
City	:	PRINCETON
State	:	MN
Zip	:	55371-2172
Country	:	US
Telephone Number	:	763-389-1313
Fax Number	:	763-389-6306

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

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	02/27/2025

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Directions to “FAIRVIEW HEALTH SERVICES ” Practice Location

Language	Start Address	Practice Location

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