Organization
FAIRVIEW PHARMACY SERVICES LLC
Active
Other names
Fairview Fridley Clinic MTM
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID FASCHING (CFO)
(612) 617-3799
Entity
Organization
Contact information
Practice address
6341 UNIVERSITY AVE NE, FRIDLEY, MN 55432-4946
(763) 586-5844
Mailing address
PO BOX 1450 # NW5823, MINNEAPOLIS, MN 55485-5823
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
07/21/2011
Last updated
03/17/2023
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