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NPI Code Detail

MEDICARE: FAIRVIEW HEALTH SERVCIES

MEDICARE: FAIRVIEW HEALTH SERVCIES
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
1333600000XPharmacy
23336L0003XLong Term Care Pharmacy
33336I0012XInstitutional Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12045643OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3260947OTHERMNPHARMACY LICENSE

General Provider Information

NPI Number : 1982788634
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAIRVIEW HEALTH SERVCIES
Provider Business Mailing Address
First Line : PO BOX 1450
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55485-7429
Country : US
Telephone Number : 612-672-5139
Fax Number : 612-672-6545
Provider Business Practice Location Address
First Line : 2450 RIVERSIDE AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55454-1450
Country : US
Telephone Number : 612-672-4200
Fax Number : 612-672-4076
Authorized Official
Title or Position : CFO
Name : DAVID FASCHING
Credential :
Telephone Number : 612-672-6601
Provider Enumeration Date : 10/25/2006
Last Update Date : 06/26/2026

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1174494827 — FAIRVIEW SPECIALTY SERVICES
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MINNEAPOLIS, MN
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1013994359 — FAIRVIEW HEALTH SERVICES
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1225525017 — DR. KENDRA KELLY MARTINEZ MD, IBCLC
Practice Location Address:
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Practice Fax:

Directions to “FAIRVIEW HEALTH SERVCIES ” Practice Location

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