Organization
FAIRVIEW PHARMACY SERVICES LLC
Active
Other names
FAIRVIEW ANDOVER 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
13819 HANSON BLVD NW, SUITE 100, ANDOVER, MN 55304-7608
(763) 862-4445
(763) 862-4462
Mailing address
NW 7429, PO BOX 1450, MINNEAPOLIS, MN 55485-7429
(612) 617-3812
(612) 672-6545
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
263115
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487839189
—
MN
01
—
2049348
PK
—
Enumeration date
01/02/2008
Last updated
03/12/2025
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