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 0&P)
(651) 632-9835
Entity
Organization
Contact information
Practice address
10961 CLUB WEST PKWY NE, STE 220, BLAINE, MN 55449-5866
(763) 852-6401
(763) 852-6402
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
—
122572
UCARE
MN
05
—
290458600
—
MN
01
—
67Q55FA
BCBS
MN
01
—
8200176
MEDICA
MN
01
—
8253
HEALTHPARTNERS
MN
Enumeration date
04/11/2006
Last updated
05/13/2025
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