Provider Demographics
NPI:1699752915
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 1:6401 FRANCE AVE S
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2104
Practice Address - Country:US
Practice Address - Phone:952-924-5000
Practice Address - Fax:952-924-5382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X, 207ZP0105X, 367500000X
MN00201282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care HospitalGroup - Single Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN5000804OtherMEDICA
MN17756TEOtherBCBS
MN182050OtherUCARE
MN5000013OtherMEDICA
MN557045002Medicaid
MN9840049OtherMEDICA
MN1014HFAOtherBCBS
MN300075OtherUCARE
MN62035FAOtherBCBS
MN557045000Medicaid
MN557045067Medicaid
MN27581OtherHEALTHPARTNERS
MN6608279OtherMEDICA
MN76896OtherPREFERREDONE
MN1006057OtherPREFERREDONE
MN17OtherHEALTHPARTNERS
MN9000019122OtherMHP
MN182050OtherUCARE
MN6608279OtherMEDICA
MN300075OtherUCARE