NPIMap

Organization Active NPI

Fairview Pharmacy Services LLC

Doing business as Fairview Pharmacy Hugo

  • Community/Retail Pharmacy
  • Hugo, MN
National Provider Identifier
1770719585
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
263415 Issued in MN
Legal business name
FAIRVIEW PHARMACY SERVICES LLC
Doing business as
Fairview Pharmacy Hugo
Practice address
14712 Victor Hugo Blvd N Ste 10
Hugo, MN 55038-6324
Phone
(651) 466-1970
Fax
(651) 466-1971
NPI assigned
Jun 8, 2009
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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X 263415 MN Primary

Addresses

Primary practice location

14712 Victor Hugo Blvd N Ste 10
Hugo, MN 55038-6324

Mailing address

NW 7429
PO Box 1450
Minneapolis, MN 55485-7429

Other identifiers 2

IdentifierTypeStateIssuer
1770719585MedicaidMN
2120494OtherPK

Other names 1

  • Fairview Pharmacy Hugo Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930042270 MN DME Supplier - Pharmacy 2961573084 Practice locations: Hugo, 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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Fairview Pharmacy Hugo14712 Victor Hugo Blvd N, Hugo, MN 55038-6324(651) 466-1970 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Insulin Infusion Pumps and/or Supplies Accepts assignmentParticipating since Jan 1, 2025

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1770719585",
    "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": "14712 VICTOR HUGO BLVD N STE 10",
            "city": "HUGO",
            "state": "MN",
            "postal_code": "550386324",
            "telephone_number": "651-466-1970",
            "fax_number": "651-466-1971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW PHARMACY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-08",
        "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": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "263415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770719585",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2120494",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairview Pharmacy Hugo",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fairview Pharmacy Hugo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hugo, 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.