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Fairview Pharmacy Services LLC — NPI 1063615979, Maple Grove, MN | NPI Central

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NPI 1063615979

OrganizationActive

Fairview Pharmacy Services LLC

NPI 1063615979 · Non-Pharmacy Dispensing Site · Maple Grove, MN

Provider details

NPI number: 1063615979
Entity type: Organization
Primary specialty: Non-Pharmacy Dispensing SiteSuppliers
Organization subpart: No
Authorized official: Sameer Badlani, Chairman of the Board(612) 617-3799
License: APPLIED (MN)

Specialties & taxonomies

Non-Pharmacy Dispensing SitePrimary332900000XLicense APPLIED (MN)
Suppliers

Practice location

14500 99th Ave N

Maple Grove, MN 55369-4730

Phone: (763) 898-1000

Fax: (763) 898-1801

Approximate (ZIP-level) locationGet directions

More MN providers

Mailing address

Po Box 7412164

Chicago, IL 60674-2164

Other names (DBA / former)

Doing business as: Fairview Maple Grove Clinic Mtm

Registry dates

Enumerated: 2007-06-07
Last updated: 2026-06-01
Certified: 2026-06-01

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.