Provider Demographics
NPI:1811077175
Name:FAIRVIEW HEALTH SERVICES
Entity type:Organization
Organization Name:FAIRVIEW HEALTH SERVICES
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 1:2450 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1450
Practice Address - Country:US
Practice Address - Phone:612-672-6000
Practice Address - Fax:612-273-4098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN017945000Medicaid
MN300050OtherUCARE
MN3903728OtherMEDICA
MN35A82FAOtherBCBS
MN62531OtherPREFERREDONE
MN42961OtherPREFERREDONE
MN4600879OtherMEDICA
MN6D402FAOtherBCBS
MN120337OtherUCARE
MN9846053OtherMEDICA
MN46773OtherHEALTHPARTNERS
MN28156OtherHEALTHPARTNERS
MN400059OtherUCARE
MN97455OtherPREFERREDONE
MN9839168OtherMEDICA
MN4700034OtherMEDICA
MN73773OtherHEALTHPARTNERS
MN28156OtherHEALTHPARTNERS
MN4700034OtherMEDICA