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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 : 1992148845
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 : 612-273-1300
Fax Number : 612-273-8727
Provider Business Practice Location Address
First Line : 2450 RIVERSIDE AVE
Second Line : STE F275 2A WEST-B
City : MINNEAPOLIS
State : MN
Zip : 55454-1450
Country : US
Telephone Number : 612-273-1300
Fax Number : 612-273-8727
Authorized Official
Title or Position : CHAIRMAN OF THE BOARD
Name : SAMEER BADLANI
Credential :
Telephone Number : 612-617-3799
Provider Enumeration Date : 04/10/2013
Last Update Date : 06/01/2026

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