Organization Name: | FAIRVIEW HEALTH SERVICES |
NPI Number: | 1316318074 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DANIEL FROMM (SENIOR VP AND CFO) |
Mailing Address: | 9220 Bass Lake Rd Suite 260 New Hope |
State: | MN US |
Postal Code: | 554283000 |
Phone Number: | 7635330363 |
Fax Number: | 7635330842 |
NPI Enumeration Date: | 10/07/2015 |
NPI Last Update Date: | 10/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |