Provider Demographics
NPI:1346722675
Name:FAIRVIEW EXPRESS CARE
Entity Type:Organization
Organization Name:FAIRVIEW EXPRESS CARE
Other - Org Name:FAIRVIEW CLINICS SPECIALTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AO DIRECTOR OF PAYER RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-672-6740
Mailing Address - Street 1:1700 UNIVERSITY AVE NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-1234
Mailing Address - Country:US
Mailing Address - Phone:612-672-2258
Mailing Address - Fax:612-672-6041
Practice Address - Street 1:400 STINSON BLVD
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-2613
Practice Address - Country:US
Practice Address - Phone:612-672-2258
Practice Address - Fax:612-672-6041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty