| Organization Name: | FAIRVIEW HEALTH SERVICES |
| NPI Number: | 1912151101 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANIEL M FROMM (CFO) |
| Mailing Address: | 11725 Stinson Ave Chisago City |
| State: | MN US |
| Postal Code: | 550139542 |
| Phone Number: | 6512578499 |
| Fax Number: | 6512578834 |
| NPI Enumeration Date: | 11/14/2008 |
| NPI Last Update Date: | 10/09/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |