Organization
FAIRVIEW PHARMACY SERVICES LLC
Active
Other names
Entira Family Clinics MTM
Organization subpart
No
Provider details
NPI number
Authorized official
SAMEER BADLANI (CHAIRMAN OF THE BOARD)
(612) 617-3799
Entity
Organization
Contact information
Practice address
2025 SLOAN PL STE 35, SAINT PAUL, MN 55117-2092
(612) 672-7005
(612) 672-7320
Mailing address
711 KASOTA AVE SE, MINNEAPOLIS, MN 55414-2842
(612) 672-5128
(612) 672-7320
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
02/01/2019
Last updated
02/07/2025
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