Provider Demographics
NPI:1477734705
Name:FAIRVIEW CLINICS
Entity type:Organization
Organization Name:FAIRVIEW CLINICS
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:612-672-6740
Mailing Address - Fax:612-884-3592
Practice Address - Street 1:13819 HANSON BLVD NW
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MN
Practice Address - Zip Code:55304-7608
Practice Address - Country:US
Practice Address - Phone:763-572-5700
Practice Address - Fax:763-392-4052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNFP917OtherPREFERRED ONE
MN98-00470OtherMEDICA NUMBER
MN507418000Medicaid
MN122190OtherUCARE MN
MNUC0003OtherUCARE URGENT CARE
MN221544OtherHEALTH PARTNERS
MN45Q12COOtherBCBS OF MN
MNFP917OtherPREFERRED ONE
MNUC0003OtherUCARE URGENT CARE