Organization
FAIRVIEW PHARMACY SERVICES LLC
Active
Other names
Fairview Lakes Pharmacy - Wyoming 340B
Organization subpart
No
Provider details
NPI number
Authorized official
SAMEER BADLANI (CHAIRMAN OF THE BOARD)
(612) 617-3799
Entity
Organization
Contact information
Practice address
5200 FAIRVIEW BLVD, WYOMING, MN 55092-8013
(651) 982-7500
Mailing address
PO BOX 1450 NW 7429, MINNEAPOLIS, MN 55485-7429
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
262536-0
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236142600
—
MN
Enumeration date
06/05/2012
Last updated
03/12/2025
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