FAIRVIEW PHARMACY SERVICES, LLC (NPI# 1003145913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003145913 |
| Entity Type | Organization |
| Organization Name | FAIRVIEW PHARMACY SERVICES, LLC |
| Other Organization Name | FAIRVIEW MESABA CLINIC MTM - HIBBING |
| Practice Address |
3605 Mayfair Ave Hibbing MN 55746-2935 |
| Mailing Address |
Po Box 1450 Nw 5823 Minneapolis MN 55485-5823 |
| Practice Telephone | 2182623441 |
| Practice Fax Number | 2183626989 |
| Enumeration Date | 2009-12-24 |
| Last Update Date | 2019-07-16 |
| Authorized Official Name | JOHN HAYES BATSON (CFO/DIRECTOR) |
| Authorized Official Telephone | 6126725301 |
| 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 Mesaba Clinic MTM - Hibbing | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386158418 | Fairview Pharmacy Services, LLC | Pharmacy | 1527 London Rd, Duluth, MN 55812-1617 | 2017-11-28 |
| 1912236829 | Fairview Pharmacy Services, LLC | Non-Pharmacy Dispensing Site | 8496 Enterprise Dr S, Mountain Iron, MN 55768-8226 | 2009-12-24 |
| 1033244074 | Fairview Pharmacy Services, LLC | Pharmacy | 2512 S 7th St Ste 105, Minneapolis, MN 55454-1404 | 2007-02-22 |
| 1063529584 | Fairview Pharmacy Services, LLC | Pharmacy | 711 Kasota Avenue Se, Minneapolis, MN 55414 | 2006-08-23 |
| 1356991566 | Fairview Pharmacy Services, LLC | Non-Pharmacy Dispensing Site | 144 S Plum St, Ellsworth, WI 54011-4137 | 2019-09-19 |
| 1346755576 | Fairview Pharmacy Services, LLC | Non-Pharmacy Dispensing Site | 1983 Sloan Pl Ste 1, Saint Paul, MN 55117-2095 | 2017-12-11 |
| 1427563659 | Fairview Pharmacy Services, LLC | Non-Pharmacy Dispensing Site | 45 10th St W, Saint Paul, MN 55102-1062 | 2017-12-11 |
| 1043725260 | Fairview Pharmacy Services, LLC | Non-Pharmacy Dispensing Site | 1600 Saint Johns Blvd Ste 101, Maplewood, MN 55109-1190 | 2017-12-11 |
| 1871008003 | Fairview Pharmacy Services, LLC | Non-Pharmacy Dispensing Site | 9900 Tamarack Rd, Woodbury, MN 55125-3609 | 2017-12-11 |
| 1124533450 | Fairview Pharmacy Services, LLC | Non-Pharmacy Dispensing Site | 980 Rice St, Saint Paul, MN 55117-4949 | 2017-12-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | FAIRVIEW PHARMACY SERVICES, LLC | 711 Kasota Ave Se, Minneapolis, MN 55414-2842 |
| Colorado Business Entities | Fairview Pharmacy Services, LLC | 711 Kasota Ave Se, Minneapolis, MN 55414 |
| Oklahoma Business Registrations | FAIRVIEW PHARMACY SERVICES, LLC | 711 Kasota Ave Se, Minneapolis, MN 55414 |
| Street Address |
3605 MAYFAIR AVE |
| City | HIBBING |
| State | MN |
| Zip Code | 55746-2935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497740054 | Anastas C Provatas | Internal Medicine | 3605 Mayfair Ave, Hibbing, MN 55746-2935 | 2005-09-20 |
| 1073094850 | Caitlin Leigh Lockard | Physician Assistant | 3605 Mayfair Ave, Hibbing, MN 55746-2935 | 2018-08-28 |
| 1134572092 | Susan Hoyum | Family Medicine | 3605 Mayfair Ave, Hibbing, MN 55746-2935 | 2016-07-15 |
| 1417309873 | Jeanne Marie Antonich | Nurse Practitioner | 3605 Mayfair Ave, Hibbing, MN 55746-2935 | 2016-07-11 |
| 1962860965 | Steven Eldor Breitbarth | Marriage & Family Therapist | 3605 Mayfair Ave, Hibbing, MN 55746-2935 | 2016-02-04 |
| 1205222833 | Gillette Children's Specialty Healthcare | Durable Medical Equipment & Medical Supplies | 3605 Mayfair Ave, Hibbing, MN 55746-2935 | 2015-04-10 |
| 1992059711 | James C Hooker | Counselor | 3605 Mayfair Ave, Hibbing, MN 55746-2341 | 2012-10-31 |
| 1043569148 | Janean Marie Mccue | Nurse Practitioner | 3605 Mayfair Ave, Fairview Mesaba Clinic, Hibbing, MN 55746 | 2012-09-05 |
| 1003170424 | Dustin Dean Lucarelli | Surgery | 3605 Mayfair Ave, Hibbing, MN 55746-2935 | 2012-06-29 |
| 1952669525 | Kasey Lynn Kapella | Family Medicine | 3605 Mayfair Ave, Hibbing, MN 55746-2935 | 2012-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922594753 | Brekke Lee Johnsrud | Dentist | 2020 1st Avenue, Hibbing, MN 55746 | 2018-07-04 |
| 1558751495 | Weston Mark Schmidt | Dental Therapist | 411 East Howard St., Jacobson Family Dentistry PC, Hibbing, MN 55746 | 2015-01-30 |
| 1467870485 | Angela Wivoda | Contractor | 302 East Howard Street, Suite 310, Hibbing, MN 55746 | 2014-04-07 |
| 1871897512 | Nicholas G Ongaro | Chiropractor | 4104 9th Ave W, Hibbing, MN 55746 | 2011-01-10 |
| 1689800153 | Kathleen M Delgreco | Social Worker | 3203 W. 3rd Ave, Hibbing, MN 55746 | 2009-06-10 |
| 1962666461 | Sereen Danielle Sharp | Internal Medicine | 3605 Mayfair Avenue, Hibbing, MN 55746 | 2008-07-14 |
| 1790999274 | Raymond N Sampson | Psychologist | 914 Minnesota St, Hibbing, MN 55746 | 2007-05-10 |
| 1598985517 | Renee Cook | Psychiatry & Neurology | 3203 W. 3rd Ave., Range Mental Health Center-perpich Building, Hibbing, MN 55746 | 2007-05-01 |
| 1841318599 | Nathan Pedersen | Dentist | 802 W 42nd St, Hibbing, MN 55746 | 2007-03-27 |
| 1558406355 | Michael John Quirk | Chiropractor | 1406 East 40th St, Hibbing, MN 55746 | 2007-02-20 |
| Find all providers in zip 55746 | ||||
| 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 | ||||
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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.