Organization
FAIRVIEW CLINICS
Active
Other names
Fairview Clinics-Bass Lake
Organization subpart
No
Provider details
NPI number
Authorized official
MAUREEN V RING (SYS DIR GOVT REIMB & NETWK REL)
(612) 672-6740
Entity
Organization
Contact information
Practice address
6320 WEDGEWOOD RD N, MAPLE GROVE, MN 55311-3647
(763) 268-0400
(763) 268-0405
Mailing address
1700 UNIVERSITY AVE W, SAINT PAUL, MN 55104-3727
(612) 672-6740
(612) 884-3592
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156927000
—
MN
Enumeration date
08/16/2007
Last updated
02/28/2025
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