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General NPI Number Information
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NPI Number | 1659653046
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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 | 09/13/2011
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 911 NORTHLAND DR
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City | PRINCETON
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State | MN
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Zip | 55371-2172
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Country | US
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Telephone | 763-389-6625
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Fax |
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Provider Business Mailing Address
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Address Line | NW 7429 PO BOX 1450
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City | MINNEAPOLIS
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State | MN
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Zip | 55485-7429
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Country | US
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Telephone |
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Fax |
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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 | 200450
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License Number State | MN
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