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General NPI Number Information
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NPI Number | 1093919482
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Entity Type | Organization
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Legal Business Name | FAIRVIEW PHARMACY SERVICES LLC
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 3650 VICTORIA ST N STE 300
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City | SHOREVIEW
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State | MN
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Zip | 55126-2906
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Country | US
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Telephone | 612-672-5260
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Fax | 612-672-5330
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Provider Business Mailing Address
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Address Line | PO BOX 1450 NW7429
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City | MINNEAPOLIS
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State | MN
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Zip | 55414
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Country | US
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Telephone | 612-672-5302
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Fax | 612-672-6659
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Authorized Official
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Title or Position | CHAIRMAN OF THE BOARD
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Name | SAMEER BADLANI
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Credential |
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Telephone | 612-617-3799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 2625425
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License Number State | MN
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