Fairview Pharmacy Services LLC
Organization Active NPI Pharmacy · Shoreview, MN
NPI 1093919482 · NPPES record last updated Jan 5, 2026
Key facts
- NPI
- 1093919482
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 2625425 (MN)
- Legal business name
- FAIRVIEW PHARMACY SERVICES LLC
- Practice address
- 3650 Victoria St N
Ste 300
Shoreview, MN 55126-2906 - Phone
- (612) 672-5260
- Fax
- (612) 672-5330
- NPI assigned
- Jun 12, 2007
- Organization subpart
- No
Authorized official
- Name
- Sameer Badlani
- Title
- Chairman of the Board
- Phone
- (612) 617-3799
Corporate family (same tax ID) 19
National Provider Directory
- Tax ID family
- Fairview Pharmacy SRV LLC
Locations
3650 Victoria St N
Ste 300
Shoreview, MN 55126
Phone (612) 672-5260
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 2625425 | MN | Yes |
Addresses
Primary practice location
3650 Victoria St N
Ste 300
Shoreview, MN 55126-2906
Mailing address
PO Box 1450 Nw7429
Minneapolis, MN 55414
Phone (612) 672-5302
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 514179601 | Medicaid | MN |
Other names
- Fairview Specialty Services Pharmacy 340B
Other providers in Shoreview, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2026. 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.