Organization Name: | FAIRVIEW CLINICS |
NPI Number: | 1043402688 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DANIEL M FROMM (CFO) |
Mailing Address: | 1440 Duckwood Dr Eagan |
State: | MN US |
Postal Code: | 551221451 |
Phone Number: | 6514068860 |
Fax Number: | 6516887864 |
NPI Enumeration Date: | 08/17/2007 |
NPI Last Update Date: | 10/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QU0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Urgent Care |
Taxonomy Definition: |