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Organization
FAIRVIEW PHARMACY SERVICES LLC
Active
Organization
FAIRVIEW PHARMACY SERVICES LLC
Active
Other names
Fairview Pharmacy Blaine
Organization subpart
No
Provider details
NPI number
Authorized official
SAMEER BADLANI (CHAIRMAN OF THE BOARD)
(612) 617-3799
Entity
Organization
Contact information
Practice address
10961 CLUB WEST PKWY, BLAINE, MN 55449-5866
(763) 528-2975
(763) 528-2988
Mailing address
NW 7429, PO BOX 1450, MINNEAPOLIS, MN 55485-7429
(612) 617-3812
(612) 672-6545
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
263513
MN
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2124194
PK
—
Enumeration date
03/17/2010
Last updated
03/12/2025
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