FAIRVIEW CLINICS NPI 1043402688

NPI Information

NPI: 1043402688
Provider Name: FAIRVIEW CLINICS

Doing Business As: M HEALTH FAIRVIEW CLINIC - EAGAN

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
3305 CENTRAL PARK VILLAGE DR
SUITE 200
EAGAN, MN
ZIP 55121
Phone: (651) 406-8860
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FAIRVIEW CLINICS is a primary care clinic center in Eagan, MN. FAIRVIEW CLINICS NPI is 1043402688. The provider is registered as an organization entity type.
The provider Is Doing Business As M Health Fairview Clinic - Eagan.

The provider's business location address is:

3305 CENTRAL PARK VILLAGE DR
SUITE 200
EAGAN, MN
ZIP 55121-707
Phone: (651) 406-8860
Fax: (651) 688-7864

The provider's authorized official is Robert Andrew Mccoy .
The authorized official title is Vp Revenue Management and has the following contact phone number (612) 672-6594.

The CLIA number assigned to this NPI record is 24D0858026 - community clinic with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 8/17/2007 and was last updated on 10/13/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QU0200X	Clinic/Center	Urgent Care			No
2	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	752820502	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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