Active NPI
Fairview Pharmacy Services LLC
- Home Infusion Therapy Pharmacy
- Shoreview, MN
National Provider Identifier
1508890450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Infusion Therapy Pharmacy
- Legal business name
- FAIRVIEW PHARMACY SERVICES LLC
- Practice address
- 3650 Victoria St N
Ste 600
Shoreview, MN 55126-2906 - Phone
- (612) 672-2233
- Fax
- (612) 672-2234
- NPI assigned
- Jul 10, 2006
- Organization subpart
- No
NPPES NPI Registry
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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | 262531 | MN | |
| Home Infusion Therapy Pharmacy | 3336H0001X | Primary | ||
| Specialty Pharmacy | 3336S0011X |
Addresses
Primary practice location
3650 Victoria St N
Ste 600
Shoreview, MN 55126-2906
Mailing address
NW 7849
PO Box 1450
Minneapolis, MN 55485-7849
Phone (612) 617-3812
Other practice location 1
290 Main St NW
Elk River, MN 55330-1270
Phone (612) 672-2233
Other practice location 2
8592 Joplin Ave
Lakeville, MN 55044-4218
Phone (612) 672-2233
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 832071300 | Medicaid | MN | |
| 2048086 | Other | PK | |
| 1508890450 | Medicaid | MN |
Other names 2
- FAIRVIEW HOME INFUSION
- FAIRVIEW HOME INFUSION RETAIL
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930096674 | MN | DME Supplier - Pharmacy | 2961573084 | Practice locations: Shoreview, MN |
National Provider Directory
National Provider DirectoryLocations
711 Kasota Ave SE
#B
Minneapolis, MN 55414
Phone (612) 672-2233
NW 7849
Minneapolis, MN 55485
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1783382400000",
"number": "1508890450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "NW 7849",
"address_2": "PO BOX 1450",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554857849",
"telephone_number": "612-617-3812",
"fax_number": "612-672-6659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3650 VICTORIA ST N",
"address_2": "STE 600",
"city": "SHOREVIEW",
"state": "MN",
"postal_code": "551262906",
"telephone_number": "612-672-2233",
"fax_number": "612-672-2234"
}
],
"practiceLocations": [
{
"address_1": "290 Main St NW",
"address_purpose": "LOCATION",
"city": "Elk River",
"state": "MN",
"postal_code": "553301270",
"country_code": "US",
"telephone_number": "612-672-2233",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8592 JOPLIN AVE",
"address_purpose": "LOCATION",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550444218",
"country_code": "US",
"telephone_number": "612-672-2233",
"fax_number": "612-672-2234",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "FAIRVIEW PHARMACY SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-10",
"last_updated": "2026-07-07",
"certification_date": "2026-07-07",
"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": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MN",
"license": "262531",
"primary": false
},
{
"code": "3336H0001X",
"taxonomy_group": "",
"desc": "Pharmacy, Home Infusion Therapy Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336S0011X",
"taxonomy_group": "",
"desc": "Pharmacy, Specialty Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "832071300",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2048086",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1508890450",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "FAIRVIEW HOME INFUSION",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "FAIRVIEW HOME INFUSION RETAIL",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Shoreview, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.