Organization
FAIRVIEW PHARMACY SERVICES LLC
Active
Other names
Fairview Pharmacy Maplewood
Organization subpart
No
Provider details
NPI number
Authorized official
SAMEER BADLANI (CHAIRMAN OF THE BOARD)
(612) 617-3799
Entity
Organization
Contact information
Practice address
2945 HAZELWOOD ST, SUITE 105, MAPLEWOOD, MN 55109-1241
(651) 471-9500
(612) 365-0384
Mailing address
NW 7429, PO BOX 1450, MINNEAPOLIS, MN 55485-7429
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
265404
MN
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2171492
PK
—
Enumeration date
08/30/2017
Last updated
03/12/2025
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