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Organization

FAIRVIEW HEALTH SERVICES

Active
Other names
Fairview Orthotics and Prosthetics
Organization subpart
No

Provider details

NPI number
Authorized official
JILL MARIE MCCARTNEY (SYSTEM EXECUTIVE HME AND O&P)
(651) 632-9835
Entity
Organization

Contact information

Practice address
14101 FAIRVIEW DRIVE, STE 300, BURNSVILLE, MN 55337-2537
(952) 892-2043
(952) 892-2139
Mailing address
1700 UNIVERSITY AVE W, SAINT PAUL, MN 55104-3727
(612) 672-6740
(612) 884-3592

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
182494
UCARE
MN
01
67Q55FA
BCBS
MN
01
8200167
MEDICA
MN
01
8253
HEALTHPARTNERS
MN
05
913103500
MN
Enumeration date
04/11/2006
Last updated
05/13/2025
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