FAIRVIEW PHARMACY SERVICES LLC (NPI# 1629357918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629357918 |
| Entity Type | Organization |
| Organization Name | FAIRVIEW PHARMACY SERVICES LLC |
| Other Organization Name | FAIRVIEW BROOKLYN PARK CLINIC MTM |
| Practice Address |
10000 Zane Ave N Brooklyn Park MN 55443-1400 |
| Mailing Address |
Po Box 1450 # Nw5823 Minneapolis MN 55485-5823 |
| Practice Telephone | 7635725700 |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2011-08-04 |
| Authorized Official Name | ROBERT BEACHER (PRESIDENT) |
| Authorized Official Telephone | 6126725200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| Other Name | Type Code |
|---|---|
| Fairview Brooklyn Park Clinic MTM | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518528397 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | Fairview Lakeville Clinic Mtm, 18580 Joplin Ave, Lakeville, MN 55044 | 2019-06-24 |
| 1083138317 | Fairview Pharmacy Services LLC | Pharmacy | 17 Exchange St W Ste 150, Saint Paul, MN 55102-1045 | 2017-07-28 |
| 1245636489 | Fairview Pharmacy Services LLC | Durable Medical Equipment & Medical Supplies | 11725 Stinson Ave Bldg B, Chisago City, MN 55013-9542 | 2014-11-17 |
| 1851792469 | Fairview Pharmacy Services LLC | Durable Medical Equipment & Medical Supplies | 14101 Fairview Dr Ste 100, Burnsville, MN 55337-2507 | 2014-09-15 |
| 1659782522 | Fairview Pharmacy Services LLC | Pharmacy | 6341 University Ave Ne Ste 101, Fridley, MN 55432-4946 | 2014-05-14 |
| 1861818387 | Fairview Pharmacy Services LLC | Durable Medical Equipment & Medical Supplies | 15075 Cimarron Ave Ste 3, Rosemount, MN 55068-1635 | 2014-03-07 |
| 1295178135 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 6440 Nicollet Ave South, Richfield, MN 55423-1613 | 2013-04-10 |
| 1992148845 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 2450 Riverside Ave South, Minneapolis, MN 55454-1400 | 2013-04-10 |
| 1891084281 | Fairview Pharmacy Services LLC | Pharmacy | 711d Kasota Ave Se, Minneapolis, MN 55414-2842 | 2011-04-06 |
| 1770719585 | Fairview Pharmacy Services LLC | Pharmacy | 14712 Victor Hugo Blvd N Ste 10, Hugo, MN 55038-6324 | 2009-06-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Fairview Pharmacy Services LLC | 160 Mine Lake Ct Ste 200, Raleigh, NC 27615-6417 |
| Street Address |
10000 ZANE AVE N |
| City | BROOKLYN PARK |
| State | MN |
| Zip Code | 55443-1400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457330656 | Arvin Mangasi Vocal | Internal Medicine | 10000 Zane Ave N, Brooklyn Park, MN 55443-1400 | 2006-01-16 |
| 1023548559 | Hilary G Wilde | Dietitian, Registered | 10000 Zane Ave N, Brooklyn Park, MN 55443-1400 | 2017-06-18 |
| 1760928683 | Michelle Justen | Social Worker | 10000 Zane Ave N, Brooklyn Park, MN 55443-1400 | 2017-01-17 |
| 1205389798 | Brianna Koopman | Registered Nurse | 10000 Zane Ave N, Brooklyn Park, MN 55443-1400 | 2016-08-01 |
| 1356749907 | Rebecca Rathjen | Social Worker | 10000 Zane Ave N, Brooklyn Park, MN 55443-1400 | 2014-12-15 |
| 1689080566 | Abass Ahmed Basha | Physician Assistant | 10000 Zane Ave N, Brooklyn Park, MN 55443-1400 | 2014-07-11 |
| 1235419326 | Katerina O. Belousova | Physician Assistant | 10000 Zane Ave N, Brooklyn Park, MN 55443-1400 | 2011-08-22 |
| 1780973610 | Fairview Express Care | Clinic/Center | 10000 Zane Ave N, Ste 202, Brooklyn Park, MN 55443-1400 | 2011-03-31 |
| 1437469350 | Fairview Health Services | Clinic/Center | 10000 Zane Ave N, Brooklyn Park, MN 55443-1400 | 2010-10-13 |
| 1164686614 | Chris M Jones | Physician Assistant | 10000 Zane Ave N, Brooklyn Park, MN 55443-1400 | 2008-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770100521 | El-lyon LLC | Home Health | 5501 88th Crescent North, Brooklyn Park, MN 55443 | 2020-06-28 |
| 1003431628 | Mercy Tasiame Quentin | Home Health | 7310 Unity Lane North, Brooklyn Park, MN 55443 | 2020-06-09 |
| 1386279719 | Andrew Sirlley Dogbe | Nursing Care | 8505 Xerxes Ln N, Brooklyn Park, MN 55443 | 2020-03-05 |
| 1952873630 | Melkezedek Care LLC | Home Health | 8525 N Edinbrook Crossing Suite 204, Brooklyn Park, MN 55443 | 2018-12-19 |
| 1487131330 | Grand St Paul Cvs L L C | Durable Medical Equipment & Medical Supplies | 4400 Oak Grove Parkway, Brooklyn Park, MN 55443 | 2018-07-24 |
| 1063901809 | Patient Centered Home Care Services, LLC. | Registered Nurse | 4127 Sunset Ter N, Brooklyn Park, MN 55443 | 2018-05-08 |
| 1093233942 | Ginni Ali | Registered Nurse | 7527 Yates Lane North, Brooklyn Park, MN 55443 | 2017-08-30 |
| 1437676335 | Uplifted Care Services LLC | Case Management | 3301 84th Ave, Brooklyn Park, MN 55443 | 2017-08-23 |
| 1912447780 | Zillah Mulubisha | Nurse Practitioner | Brooklyn Park Clinic, 7650 Zane Ave N, Minneapolis, MN 55443 | 2017-02-27 |
| 1356898985 | Abdul Kabba | Driver | 79oo Lad Parkway, Brooklyn Park, MN 55443 | 2016-09-01 |
| Find all providers in zip 55443 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518528397 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | Fairview Lakeville Clinic Mtm, 18580 Joplin Ave, Lakeville, MN 55044 | 2019-06-24 |
| 1851856504 | Tareen Dermatology, Pa | Non-Pharmacy Dispensing Site | 2945 Hazelwood St Ste 230, Maplewood, MN 55109-1241 | 2019-02-07 |
| 1417450651 | Cerner Health Connections, Inc | Non-Pharmacy Dispensing Site | 4001 Lexington Ave N Ste C2-435, Arden Hills, MN 55126-2934 | 2018-03-14 |
| 1316461593 | Fairview Pharmacy Service LLC | Non-Pharmacy Dispensing Site | 7250 France Ave S Ste 410, Edina, MN 55435-4314 | 2017-07-31 |
| 1346653052 | Advanced Spine and Pain Clinics of Mn, LLC | Non-Pharmacy Dispensing Site | 308 Brighton Ave, Suite D, Buffalo, MN 55313-2303 | 2014-06-10 |
| 1407296148 | Group Health Plan Inc | Non-Pharmacy Dispensing Site | 1833 2nd Ave, Anoka, MN 55303-2432 | 2013-06-26 |
| 1295178135 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 6440 Nicollet Ave South, Richfield, MN 55423-1613 | 2013-04-10 |
| 1992148845 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 2450 Riverside Ave South, Minneapolis, MN 55454-1400 | 2013-04-10 |
| 1083984876 | Mayo Clinic Health System-southeast Minnesota Region | Non-Pharmacy Dispensing Site | 32021 County 24 Boulevard, Cannon Falls, MN 55009-1824 | 2012-01-10 |
| 1255623765 | Mankato Clinic, Ltd | Non-Pharmacy Dispensing Site | 305 Main St Ne, Mapleton, MN 56065 | 2011-05-03 |
| Find all providers with the same taxonomy | ||||
| City | BROOKLYN PARK |
| Zip Code | 55443 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.