Provider Demographics
NPI:1023096922
Name:FAIRVIEW EXPRESS CARE
Entity type:Organization
Organization Name:FAIRVIEW EXPRESS CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SYS DIR GOVT REIMB & NETWK REL
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:V
Authorized Official - Last Name:RING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-672-6740
Mailing Address - Street 1:1700 UNIVERSITY AVE W
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-3727
Mailing Address - Country:US
Mailing Address - Phone:612-672-6724
Mailing Address - Fax:612-884-3592
Practice Address - Street 1:6545 FRANCE AVE S
Practice Address - Street 2:STE 450
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2131
Practice Address - Country:US
Practice Address - Phone:952-924-1520
Practice Address - Fax:952-924-8090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN181002OtherUCARE
MN181003OtherUCARE
MN291923000Medicaid
MN335459800Medicaid
MN181001OtherUCARE
MN69Q26INOtherBCBS
MN181000OtherUCARE
MN9864672OtherMEDICA
MN004950600Medicaid
MN107599OtherHEALTHPARTNERS
MN9864671OtherMEDICA
MN9864673OtherMEDICA
MN487445200Medicaid
MN886475600Medicaid
MN181004OtherUCARE
MN458990400Medicaid
MN978127700Medicaid
MN9864670OtherMEDICA
MN9864674OtherMEDICA
MN9864674OtherMEDICA
MN291923000Medicaid
MNC02742Medicare PIN