NPIMap

Organization Active NPI

Fairview Pharmacy Services LLC

Doing business as Fairview University Clinic Pharmacy

  • Community/Retail Pharmacy
  • Minneapolis, MN
National Provider Identifier
1619909694
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
262549 Issued in MN
Legal business name
FAIRVIEW PHARMACY SERVICES LLC
Doing business as
Fairview University Clinic Pharmacy
Practice address
909 Fulton St SE FL 1
Mail Code 2121Aa
Minneapolis, MN 55455-4800
Phone
(612) 676-4100
Fax
(612) 676-4131
NPI assigned
Jul 7, 2006
Last updated
Mar 12, 2025By the provider in NPPES
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 BadlaniNPI 1699795302
Title
Chairman of the Board
Phone
(612) 617-3799

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Clinic Pharmacy 3336C0002X NU
Community/Retail Pharmacy 3336C0003X 262549 MN Primary
Specialty Pharmacy 3336S0011X NU

Addresses

Primary practice location

909 Fulton St SE FL 1
Mail Code 2121Aa
Minneapolis, MN 55455-4800

Mailing address

NW 7429
PO Box 1450
Minneapolis, MN 55485-7429

Other identifiers 3

IdentifierTypeStateIssuer
1619909694MedicaidMN
115103700MedicaidMN
2045640OtherPK

Other names 1

  • FAIRVIEW UNIVERSITY CLINIC PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930004095 MN DME Supplier - Pharmacy 2961573084 Practice locations: Minneapolis, 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…

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 23

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

13819 Hanson Blvd NW
#100
Andover, MN 55304
Phone (763) 862-4445

14101 Fairview Dr
Ste 100
Burnsville, MN 55337
Phone (952) 405-5630

11725 Stinson Ave
#B
Chisago City, MN 55013
Phone (651) 213-8080

11725 Stinson Ave
Bldg B
Chisago City, MN 55013
Phone (651) 213-8080

4000 Central Ave NE
#100
Columbia Heights, MN 55421
Phone (763) 236-2596

3305 Central Park Village Dr
Ste 100
Eagan, MN 55121
Phone (651) 406-8980

6401 France Ave S
Ste Sl
Edina, MN 55435
Phone (952) 924-1400

6545 France Ave S
Ste 100
Edina, MN 55435
Phone (612) 716-3732

290 Main St NW
Ste 110
Elk River, MN 55330
Phone (763) 241-5890

6341 University Ave NE
Ste 101
Fridley, MN 55432
Phone (763) 586-5981

14712 Victor Hugo Blvd N
Ste 10
Hugo, MN 55038
Phone (651) 466-1970

115 2nd Ave NW
Milaca, MN 56353
Phone (320) 983-3191

2847 Johnson St NE
Minneapolis, MN 55418
Phone (612) 789-7277

424 Harvard St SE
Ste 300
Minneapolis, MN 55455
Phone (612) 626-0401

500 Harvard St SE
Ste 2130K
Minneapolis, MN 55455
Phone (612) 273-2121

516 Delaware St SE
#812
Minneapolis, MN 55455
Phone (612) 626-2828

516 Delaware St SE
Ste 2350
Minneapolis, MN 55455
Phone (612) 626-2828

711 Kasota Ave SE
#C
Minneapolis, MN 55414
Phone (612) 672-5735

711 Kasota Ave SE
#D
Minneapolis, MN 55414
Phone (612) 672-5694

909 Fulton St SE
#2121
Minneapolis, MN 55455
Phone (612) 626-6688

909 Fulton St SE
Fl 1
Minneapolis, MN 55455
Phone (612) 676-4100

15075 Cimarron Ave
Ste 3
Rosemount, MN 55068
Phone (651) 322-8855

2270 Ford Pkwy
Ste 103
Saint Paul, MN 55116
Phone (651) 696-5020

2270 Ford Pkwy
Ste 130
Saint Paul, MN 55116
Phone (651) 696-5020

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1619909694",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 FULTON ST SE FL 1",
            "address_2": "MAIL CODE 2121AA",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554554800",
            "telephone_number": "612-676-4100",
            "fax_number": "612-676-4131"
        }
    ],
    "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "262549",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619909694",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115103700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2045640",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAIRVIEW UNIVERSITY CLINIC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FAIRVIEW UNIVERSITY CLINIC 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.