Provider Demographics
NPI:1497025910
Name:FAIRVIEW CLINICS
Entity Type:Organization
Organization Name:FAIRVIEW CLINICS
Other - Org Name:ONCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP / CFO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:FROMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-672-4976
Mailing Address - Street 1:PO BOX 9372
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55440-9372
Mailing Address - Country:US
Mailing Address - Phone:612-672-5390
Mailing Address - Fax:
Practice Address - Street 1:451 LEXINGTON PKWY N
Practice Address - Street 2:SUITE 300
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4636
Practice Address - Country:US
Practice Address - Phone:612-672-1900
Practice Address - Fax:612-273-1919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-02
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center