Organization
FAIRVIEW SPECIALTY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH CHARLES GAYLORD (CHIEF FINANCIAL OFFICER)
(612) 672-6119
Entity
Organization
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(855) 324-7843
Mailing address
1700 UNIVERSITY AVE W, SAINT PAUL, MN 55104-3727
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
08/29/2025
Last updated
08/29/2025
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