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Organization
FAIRVIEW PHARMACY SERVICES LLC
Active
Organization
FAIRVIEW PHARMACY SERVICES LLC
Active
Other names
Fairview Pharmacy Maplewood
Organization subpart
No
Provider details
NPI number
Authorized official
SAMEER BADLANI (CHAIRMAN OF THE BOARD)
(612) 617-3799
Entity
Organization
Contact information
Practice address
2945 HAZELWOOD ST, SUITE 105, MAPLEWOOD, MN 55109-1241
(651) 471-9500
(612) 365-0384
Mailing address
NW 7429, PO BOX 1450, MINNEAPOLIS, MN 55485-7429
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
265404
MN
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2171492
PK
—
Enumeration date
08/30/2017
Last updated
03/12/2025
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