M Health Fairview Clinic - Andover

LBN: Fairview Express Care
M Health Fairview Clinic - Andover is an health care organization with primary practice located at 13819 Hanson Blvd Nw , Andover MN 55304-7608. The organization recently has only one registered license in Suppliers / Eyewear Supplier (Equipment, not the service), which is considered as the primary health care specialty. Fairview Express Care can be contacted via phone (763) 572-5700, or through Mccoy, Robert Andrew via phone (612) 672-6594.

Contact Information

Primary practice address
13819 Hanson Blvd Nw Andover MN 55304-7608
Fax: (763) 392-4052
Website:
Authorized official contact:
Name: Mccoy, Robert Andrew

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X

Profile Details

NPI number 1861674665
LBN Legal business name Fairview Express Care
DBA Doing business as M Health Fairview Clinic - Andover
Authorized official Mccoy, Robert Andrew
Entity Organization
Organization subpart 1 No
Enumeration date Dec 4th, 2007
Last updated Nov 10th, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861674665 NPPES
Minnesota Other 45Q12CO BCBS DME NUMBER
Minnesota MEDICAID 819418000 BCBS DME NUMBER

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