{
"Npi": {
"NPI": "1093919482",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FAIRVIEW PHARMACY SERVICES LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 1450 NW7429",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MINNEAPOLIS",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55414",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "612-672-5302",
"MailingAddressFaxNumber": "612-672-6659",
"FirstLinePracticeLocationAddress": "3650 VICTORIA ST N",
"SecondLinePracticeLocationAddress": "STE 300",
"PracticeLocationAddressCityName": "SHOREVIEW",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55126-2906",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "612-672-5260",
"PracticeLocationAddressFaxNumber": "612-672-5330",
"EnumerationDate": "06/12/2007",
"LastUpdateDate": "08/28/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BADLANI",
"AuthorizedOfficialFirstName": "SAMEER",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CHAIRMAN OF THE BOARD",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "612-617-3799",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "2625425",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}