NPIMap

Organization Active NPI

Fairview Pharmacy Services LLC

Doing business as Fairview Fulton Primary Care Clinic MTM

  • Non-Pharmacy Dispensing Site
  • Minneapolis, MN
National Provider Identifier
1477698744
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
2625496 Issued in MN
Legal business name
FAIRVIEW PHARMACY SERVICES LLC
Doing business as
Fairview Fulton Primary Care Clinic MTM
M Health Primary Care Clinic MTM
Practice address
909 Fulton St SE
Minneapolis, MN 55455-4800
Phone
(612) 676-5824
NPI assigned
Feb 21, 2007
Last updated
Jul 30, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 2625496 MN Primary

Addresses

Primary practice location

909 Fulton St SE
Minneapolis, MN 55455-4800

Mailing address

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (612) 676-5824

Other names 2

  • Fairview Fulton Primary Care Clinic MTM Doing business as
  • M Health Primary Care Clinic MTM Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fairview Pharmacy SRV LLC71 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785369600000",
    "number": "1477698744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727",
            "telephone_number": "612-676-5824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 FULTON ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554554800",
            "telephone_number": "612-676-5824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW PHARMACY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "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": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "MN",
            "license": "2625496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairview Fulton Primary Care Clinic MTM",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "M Health Primary Care Clinic MTM",
            "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 Jul 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.