NPIMap

Organization Active NPI

Fairview Pharmacy Services LLC

  • Community/Retail Pharmacy
  • Minneapolis, MN
National Provider Identifier
1154353142
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
262544 Issued in MN
Legal business name
FAIRVIEW PHARMACY SERVICES LLC
Practice address
500 Harvard St SE
Minneapolis, MN 55455-0363
Phone
(612) 273-2121
Fax
(612) 273-8156
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X 262544 MN Primary

Addresses

Primary practice location

500 Harvard St SE
Minneapolis, MN 55455-0363

Mailing address

NW 7429
PO Box 1450
Minneapolis, MN 55485-7429
Phone (612) 672-5139

Other identifiers 3

IdentifierTypeStateIssuer
2048311OtherPK
335408300MedicaidMN
1154353142MedicaidMN

Other names 1

  • FAIRVIEW UNIVERSITY DISCHARGE PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930045818 MN DME Supplier - Pharmacy 2961573084 Practice locations: Minneapolis, MN

National Provider Directory

National Provider Directory

Locations

500 Harvard St SE
Ste 3107
Minneapolis, MN 55455

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1154353142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NW 7429",
            "address_2": "PO BOX 1450",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554857429",
            "telephone_number": "612-672-5139",
            "fax_number": "612-672-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HARVARD ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550363",
            "telephone_number": "612-273-2121",
            "fax_number": "612-273-8156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW PHARMACY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "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": "262544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2048311",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "335408300",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154353142",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAIRVIEW UNIVERSITY DISCHARGE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FAIRVIEW UNIVERSITY DISCHARGE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.