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NPI Code Detail

MEDICARE: FAIRVIEW PHARMACY SERVICES, LLC

MEDICARE: FAIRVIEW PHARMACY SERVICES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332900000XNon-Pharmacy Dispensing Site

General Provider Information

NPI Number : 1780199026
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAIRVIEW PHARMACY SERVICES, LLC
Provider Business Mailing Address
First Line : PO BOX 7412164
Second Line :
City : CHICAGO
State : IL
Zip : 60674-2164
Country : US
Telephone Number : 651-232-4800
Fax Number :
Provider Business Practice Location Address
First Line : 1390 UNIVERSITY AVE W
Second Line :
City : SAINT PAUL
State : MN
Zip : 55104-4001
Country : US
Telephone Number : 651-232-4800
Fax Number :
Authorized Official
Title or Position : CHAIRMAN OF THE BOARD
Name : SAMEER BADLANI
Credential :
Telephone Number : 612-617-3799
Provider Enumeration Date : 12/08/2017
Last Update Date : 06/01/2026

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Directions to “FAIRVIEW PHARMACY SERVICES, LLC ” Practice Location

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