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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 Site2625386MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760527030
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAIRVIEW PHARMACY SERVICES LLC
Provider Business Mailing Address
First Line : PO BOX 1450 NW7429
Second Line : ATTN CONTRACTING
City : MINNEAPOLIS
State : MN
Zip : 55485
Country : US
Telephone Number : 612-672-5174
Fax Number : 612-672-6659
Provider Business Practice Location Address
First Line : 2847 JOHNSON ST NE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55418-3055
Country : US
Telephone Number : 612-789-7277
Fax Number : 612-706-4591
Authorized Official
Title or Position : CHAIRMAN OF THE BOARD
Name : SAMEER BADLANI
Credential :
Telephone Number : 612-617-3799
Provider Enumeration Date : 02/21/2007
Last Update Date : 03/12/2025

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Directions to “FAIRVIEW PHARMACY SERVICES LLC ” Practice Location

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