Fairview Pharmacy Services LLC

Key facts

NPI: 1013035120
Entity type: Organization (NPI type 2)
Primary specialty: Community/Retail Pharmacy 3336C0003X
License: 262967 (MN)
Legal business name: FAIRVIEW PHARMACY SERVICES LLC
Practice address: 424 Harvard St SE
Ste 300
Minneapolis, MN 55455-0362
Phone: (612) 626-6429
Fax: (612) 626-6208
NPI assigned: Mar 27, 2007
Organization subpart: No

Authorized official

Name: Sameer Badlani
Title: Chairman of the Board
Phone: (612) 617-3799

National Provider Directory

Locations

424 Harvard St SE
Ste 300
Minneapolis, MN 55455
Phone (612) 626-0401

7429 NW
Minneapolis, MN 55485

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Durable Medical Equipment & Medical Supplies	332B00000X
Clinic Pharmacy	3336C0002X
Community/Retail Pharmacy	3336C0003X	262967	MN	Yes

Addresses

Primary practice location

424 Harvard St SE
Ste 300
Minneapolis, MN 55455-0362

Mailing address

7429 NW
PO Box 1450
Minneapolis, MN 55485-7429
Phone (612) 672-5138

Other identifiers

Identifier	Type	State	Issuer
1013035120	Medicaid	MN
2049219	Other		PK

Other names

FAIRVIEW UNIVERSITY MASONIC PHARMACY Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 12, 2025.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1013035120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7429 NW",
            "address_2": "PO BOX 1450",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554857429",
            "telephone_number": "612-672-5138",
            "fax_number": "612-672-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 HARVARD ST SE",
            "address_2": "STE 300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550362",
            "telephone_number": "612-626-6429",
            "fax_number": "612-626-6208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW PHARMACY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A",
        "authorized_official_last_name": "BADLANI",
        "authorized_official_first_name": "SAMEER",
        "authorized_official_title_or_position": "CHAIRMAN OF THE BOARD",
        "authorized_official_telephone_number": "612-617-3799"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "262967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013035120",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2049219",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAIRVIEW UNIVERSITY MASONIC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FAIRVIEW UNIVERSITY MASONIC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneapolis, MN

All providers in Minneapolis, MN · Community/Retail Pharmacy in Minnesota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.