Organization
FAIRVIEW PHARMACY SERVICES LLC
Active
Other names
FAIRVIEW UNIVERSITY MASONIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SAMEER BADLANI (CHAIRMAN OF THE BOARD)
(612) 617-3799
Entity
Organization
Contact information
Practice address
424 HARVARD ST SE, STE 300, MINNEAPOLIS, MN 55455-0362
(612) 626-6429
(612) 626-6208
Mailing address
7429 NW, PO BOX 1450, MINNEAPOLIS, MN 55485-7429
(612) 672-5138
(612) 672-6659
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
262967
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013035120
—
MN
01
—
2049219
PK
—
Enumeration date
03/27/2007
Last updated
03/12/2025
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