Fairview Pharmacy Services LLC
Organization Active NPI Community/Retail Pharmacy · Edina, MN
NPI 1528090503 · NPPES record last updated Jul 30, 2026
Key facts
- NPI
- 1528090503
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 262528 (MN)
- Legal business name
- FAIRVIEW PHARMACY SERVICES LLC
- Practice address
- 6401 France Ave S Ste SL-1
Edina, MN 55435-2104 - Phone
- (952) 924-1400
- Fax
- (952) 924-1404
- NPI assigned
- Jul 7, 2006
- Organization subpart
- No
Authorized official
- Name
- Sameer Badlani
- Title
- Chairman of the Board
- Phone
- (612) 617-3799
Other NPIs on the same Medicare enrollment 23
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930061348 | MN | DME Supplier - Pharmacy | 2961573084 | Practice locations: Edina, MN |
| O20200409000162 | MN | Part B Supplier - Mass Immunization (Roster Biller Only) | 2961573084 |
23 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Maplewood, MN; Minneapolis, MN; New Brighton, MN; North Branch, MN; Princeton, MN; Prior Lake, MN; Rosemount, MN; Saint Paul, MN… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Clinic Pharmacy | 3336C0002X | |||
| Community/Retail Pharmacy | 3336C0003X | 262528 | MN | Yes |
Addresses
Primary practice location
6401 France Ave S Ste SL-1
Edina, MN 55435-2104
Mailing address
PO Box 1450 NW 7429
Minneapolis, MN 55485-7429
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 358613800 | Medicaid | MN | |
| 2046650 | Other | PK | |
| 1528090503 | Medicaid | MN |
Other names
- FAIRVIEW EDINA PHARMACY
Other providers in Edina, MN
- Fairview Health Services
- Fairview Health Services
- Fairview Health Services
- Fairview Health Services
- Fairview Pharmacy Service LLC
- Fairview Pharmacy Services LLC
- Fairview Pharmacy Services LLC
- Fairview Pharmacy Services LLC
- Fake Business Name
- James E. Faliszek
All providers in Edina, 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 Jul 30, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.