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Organization

FAIRVIEW PHARMACY SERVICES LLC

Active
Other names
FAIRVIEW CENTENNIAL LAKES 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
7373 FRANCE AVE S STE 206, EDINA, MN 55435-4538
(952) 985-8160
(952) 985-8188
Mailing address
PO BOX 1450, MINNEAPOLIS, MN 55485-1450

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
Primary
2625250
MN
3336C0002X
Clinic Pharmacy
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2419201
OTHER ID NUMBER
05
877905800
MN
Enumeration date
07/10/2006
Last updated
03/12/2025
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