Fairview Pharmacy Services LLC
Fairview Pharmacy Services LLC is a healthcare organization registered as Community/Retail Pharmacy in Maple Grove, MN, holding Type 2 (organization) NPI 1124228176 since 2007. The authorized official on file is Sameer Badlani, Chairman of the Board.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1124228176 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Fairview Pharmacy Services LLC |
| Other name | <Unavail> |
| Practice address | 14500 99TH AVE N, 1A029, Maple Grove, MN, 55369 |
| Phone | 7638981800 |
| Fax | 7638981801 |
| Enumeration date | 2007-07-18 |
| Last updated in NPPES | 2025-03-12 |
Authorized official
| Name | Sameer Badlani |
|---|---|
| Title | Chairman of the Board |
| Phone | 6126173799 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 3336C0002X | Clinic Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | 263036 | MN |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124228176 | Medicaid | MN | — |
| 2049243 | Other | — | PK |
Copy-ready billing details
Provider: Fairview Pharmacy Services LLC NPI: 1124228176 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 14500 99TH AVE N, 1A029, Maple Grove, MN, 55369
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1649275777 | Jeannette Wilcox | Individual | Radiation Oncology Physician | Maple Grove, MN |
| 1477543957 | Kathleen Demanivel | Individual | Dermatology Physician | Maple Grove, MN |
| 1932171188 | Libin Ho | Individual | Internal Medicine Physician | Maple Grove, MN |
| 1811958424 | Maryam Moghaddam | Individual | Obstetrics & Gynecology Physician | Maple Grove, MN |
| 1013975663 | Renee Haroldson | Individual | Hand Occupational Therapist | Maple Grove, MN |
| 1164474870 | Archana Ramaswamy | Individual | Surgery Physician | Maple Grove, MN |
| 1528001575 | Ashok Patel | Individual | Internal Medicine Physician | Maple Grove, MN |
| 1023034980 | Barbara Benson | Individual | Registered Dietitian | Maple Grove, MN |
Verify this record
Cross-check NPI 1124228176 against the authoritative CMS record: view Fairview Pharmacy Services LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Where is Fairview Pharmacy Services LLC located?
How current is this record?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-03-12.