FAIRVIEW PHARMACY SERVICES, LLC (NPI# 1114432440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114432440 |
| Entity Type | Organization |
| Organization Name | FAIRVIEW PHARMACY SERVICES, LLC |
| Other Organization Name | HEALTHEAST GRAND AVENUE CLINIC MTM |
| Practice Address |
870 Grand Ave Saint Paul MN 55105-3291 |
| Mailing Address |
Po Box 9372 Minneapolis MN 55440-9372 |
| Practice Telephone | 6513265800 |
| Practice Fax Number | 6126727320 |
| Mailing Telephone | 6513265800 |
| Mailing Fax Number | 6126725320 |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2017-12-08 |
| Authorized Official Name | ROBERT BEACHER (PRESIDENT) |
| Authorized Official Telephone | 6126725139 |
| 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 |
|---|---|
| HealthEast Grand Avenue Clinic MTM | 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 |
| Street Address |
870 GRAND AVE |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55105-3291 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295711265 | Rolf Peter Ulland | Obstetrics & Gynecology | 870 Grand Ave, Saint Paul, MN 55105-3291 | 2005-12-21 |
| 1336671205 | Christina Rose Werman | Family Medicine | 870 Grand Ave, Saint Paul, MN 55105-3291 | 2017-03-30 |
| 1275918658 | Jenna Lynn Larson Viland | Nurse Practitioner | 870 Grand Ave, Saint Paul, MN 55105-3291 | 2015-07-27 |
| 1942649181 | Theresa M Havalad | Nurse Practitioner | 870 Grand Ave, Saint Paul, MN 55105-3291 | 2013-06-20 |
| 1518005230 | Laurie Radovsky | Family Medicine | 870 Grand Ave, Saint Paul, MN 55105-3291 | 2007-02-02 |
| 1487733408 | Prairiestone Pharmacy LLC | Pharmacist | 870 Grand Ave, Saint Paul, MN 55105-3291 | 2006-11-02 |
| 1912084674 | Shabbir S Dawoodbhai | Pharmacist | 870 Grand Ave, Saint Paul, MN 55105-3291 | 2006-11-01 |
| 1790872331 | Daniel J Sullivan | Family Medicine | 870 Grand Ave, Saint Paul, MN 55105-3291 | 2006-10-06 |
| 1558473702 | Bernadette Lee Clevenger | Family Medicine | 870 Grand Ave, Saint Paul, MN 55105-3291 | 2006-08-31 |
| 1356458723 | Gervais Patrick Chokote Moche | Family Medicine | 870 Grand Ave, Saint Paul, MN 55105-3291 | 2006-08-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437704020 | Grand Avenue Smiles | Dentist | 1845 Grand Avenue, St. Paul, MN 55105 | 2019-08-09 |
| 1205304839 | Michelle Marie Loken Price | Acupuncturist | 877 Lincoln Ave, Saint Paul, MN 55105 | 2018-11-13 |
| 1326566936 | Becky Lynn Lawyer | Counselor | 1704 Palace Ave, St Paul, MN 55105 | 2017-09-04 |
| 1679020226 | Internal Revolution Counseling and Consulting, L.L.C. | Psychologist | 1123 Grand Avenue, Suite 201, Saint Paul, MN 55105 | 2016-09-01 |
| 1487059689 | Jennifer Mason | Lactation Consultant, Non-RN | 1382 Summit Ave, Saint Paul, MN 55105 | 2014-10-30 |
| 1679818850 | Marc Lane Wolfson | Registered Nurse | 1148 Grand Avenue, St. Paul, MN 55105 | 2012-11-29 |
| 1457602781 | Charting Your Success | Social Worker | 2050 St Clair Avenue, Suite 1e, St Paul, MN 55105 | 2012-09-26 |
| 1871867549 | Stacia Hanson Ma Lp LLC | Psychologist | 889 Grand Avenue, Suite 203, St Paul, MN 55105 | 2012-02-28 |
| 1265718142 | Caitlin Marie Young | Midwife | 968 Grand Ave., St. Paul, MN 55105 | 2011-10-24 |
| 1659512622 | Wellness Cooperative LLC | Chiropractor | 976 Grand Ave., St. Paul, MN 55105 | 2009-03-20 |
| Find all providers in zip 55105 | ||||
| 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 |
|---|---|---|---|---|
| 1811039050 | Family Healthservices Minnesota, P.a | Non-Pharmacy Dispensing Site | 3550 Labore Rd, Suite 7, Saint Paul, MN 55110-7505 | 2007-02-13 |
| 1891319943 | Gillette Children's Specialty Healthcare | Non-Pharmacy Dispensing Site | 200 University Ave E, Saint Paul, MN 55101-2507 | 2020-06-04 |
| 1689230971 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 580 Rice St, Saint Paul, MN 55103-2148 | 2019-05-13 |
| 1750947040 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 1414 Maryland Ave E, Saint Paul, MN 55106-2824 | 2019-05-13 |
| 1891250031 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 2025 Sloan Pl Ste 35, Saint Paul, MN 55117-2092 | 2019-02-01 |
| 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 |
| 1124533450 | Fairview Pharmacy Services, LLC | Non-Pharmacy Dispensing Site | 980 Rice St, Saint Paul, MN 55117-4949 | 2017-12-08 |
| 1780199026 | Fairview Pharmacy Services, LLC | Non-Pharmacy Dispensing Site | 1390 University Ave W, Saint Paul, MN 55104-4001 | 2017-12-08 |
| 1427452655 | Group Health Plan, Inc. | Non-Pharmacy Dispensing Site | 8200 Coral Sea St Ne, Saint Paul, MN 55112 | 2014-10-17 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55105 |
Please comment or provide details below to improve the information on FAIRVIEW PHARMACY SERVICES, LLC.
| 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.