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FAIRVIEW PHARMACY SERVICES LLC
NPI 1063615979
Non-Pharmacy Dispensing Site in Maple Grove, MN

Active since June 07, 2007
14500 99TH AVE N, MAPLE GROVE, MN 55369(763) 898-1000(763) 898-1801 Get Directions Write a Review

NPPES record last updated: June 1, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 1, 2026, Mar 12, 2025, Apr 12, 2023 and 4 more (7 updates tracked since 2020).

About Fairview Pharmacy Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAIRVIEW PHARMACY SERVICES LLC (NPI 1063615979), doing business as Fairview Maple Grove Clinic Mtm, is a healthcare organization registered as a non-pharmacy dispensing site in Maple Grove, Minnesota and active in the NPI registry since June 2007. The organization lists Sameer Badlani, Chairman Of The Board, as its authorized official.

NPPES Registry Identity

NPI1063615979
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameFAIRVIEW PHARMACY SERVICES LLC
Location Address14500 99TH AVE NMaple Grove, MN 55369-4730
Mailing AddressPo Box 7412164Chicago, IL 60674-2164 · (763) 898-1000 · Fax (763) 898-1801
Phone(763) 898-1000
Fax(763) 898-1801
Organization SubpartNo
Authorized OfficialSameer BadlaniChairman Of The Board · (612) 617-3799
Enumeration DateJune 7, 2007
Last NPPES UpdateJune 1, 20267 updates tracked since enumeration
NPPES CertifiedJune 1, 2026
✔ NPI 1063615979 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License✔ Licensed in MN · APPLIED
Definition

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.)

14500 99TH AVE N, Maple Grove, MN 55369
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Other Names 1

Doing Business AsFairview Maple Grove Clinic Mtm

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEATHER LAGE RN, CDE
Registered Nurse (Diabetes Educator)
14500 99TH AVE N
MAPLE GROVE, MN 55369
Hennepin County (763) 898-1000
SARAH NICOLE OLSON VENNING LICSW
Social Worker (Clinical)
14500 99TH AVE N
MAPLE GROVE, MN 55369
Hennepin County (651) 600-0342
MS. RENEE HAROLDSON OTRL CHT
Occupational Therapist (Hand)
14500 99TH AVE N, #1-210
MAPLE GROVE, MN 55369
Hennepin County (763) 898-1778
BARBARA I BENSON RD
Dietitian, Registered
14500 99TH AVE N
MAPLE GROVE, MN 55369
Hennepin County (763) 898-1073
DR. JENNIFER MERTZ RIEGEL PHARM.D
Pharmacist
14500 99TH AVE N
MAPLE GROVE, MN 55369
Hennepin County (763) 898-1806
DR. MICHAELA MONETTI PH.D., LP
Psychologist (Clinical)
14500 99TH AVE N
MAPLE GROVE, MN 55369
Hennepin County (763) 898-1000
KATTI LAUREN WOERNER D.O
Internal Medicine (Nephrology)
14500 99TH AVE N, MEDICAL SPECIALTY CLINIC
MAPLE GROVE, MN 55369
Hennepin County (763) 898-1000
JENNIFER BREMER RD, LD
Dietitian, Registered
14500 99TH AVE N
MAPLE GROVE, MN 55369
Hennepin County (763) 898-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fairview Pharmacy Services LLC's NPI number?

The NPI number for Fairview Pharmacy Services LLC is 1063615979. It was assigned to this organization in the NPPES registry on June 7, 2007. The provider is doing business as Fairview Maple Grove Clinic MTM.

Where is Fairview Pharmacy Services LLC located?

Fairview Pharmacy Services LLC is located at 14500 99th Ave N, Maple Grove, MN 55369. The listed phone number is (763) 898-1000.

What is Fairview Pharmacy Services LLC's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

When was this NPI record last updated?

The NPPES record for Fairview Pharmacy Services LLC was last updated on June 1, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.