NPIMap

Organization Active NPI

Fairview Pharmacy Services LLC

Doing business as Fairview Centennial Lakes Pharmacy

  • Pharmacy
  • Edina, MN
National Provider Identifier
1699709543
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
2625250 Issued in MN
Legal business name
FAIRVIEW PHARMACY SERVICES LLC
Doing business as
Fairview Centennial Lakes Pharmacy
Practice address
7373 France Ave S Ste 206
Edina, MN 55435-4538
Phone
(952) 985-8160
Fax
(952) 985-8188
NPI assigned
Jul 10, 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 Badlani
Title
Chairman of the Board
Phone
(612) 617-3799

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 2625250 MN Primary
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

7373 France Ave S Ste 206
Edina, MN 55435-4538

Mailing address

PO Box 1450
Minneapolis, MN 55485-1450

Other identifiers 3

IdentifierTypeStateIssuer
2419201OtherOTHER ID NUMBER
2419201OtherOTHER ID NUMBER-COMMERCIAL NUMBER
877905800MedicaidMN

Other names 1

  • FAIRVIEW CENTENNIAL LAKES PHARMACY 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

Locations

7373 France Ave S
Ste 206
Edina, MN 55435
Phone (952) 985-8160

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": "1741737600000",
    "number": "1699709543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1450",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554851450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 FRANCE AVE S STE 206",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354538",
            "telephone_number": "952-985-8160",
            "fax_number": "952-985-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW PHARMACY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "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": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MN",
            "license": "2625250",
            "primary": true
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2419201",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2419201",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "877905800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAIRVIEW CENTENNIAL LAKES PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FAIRVIEW CENTENNIAL LAKES PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edina, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.