Fairview Eden Prairie Clinic Mtm

LBN: Fairview Pharmacy Services Llc
Fairview Eden Prairie Clinic Mtm is an health care organization with primary practice located at 830 Prairie Center Dr , Eden Prairie MN 55344-7301. The organization recently has only one registered license in Suppliers / Non-Pharmacy Dispensing Site, which is considered as the primary health care specialty. Fairview Pharmacy Services Llc can be contacted via phone (952) 826-6500, or through Fasching, David via phone (612) 617-3799.

Contact Information

Primary practice address
830 Prairie Center Dr Eden Prairie MN 55344-7301
Phone: (952) 826-6500
Fax: (952) 946-0925
Website:
Map and Directions
Authorized official contact:
Name: Fasching, David
Phone: (612) 617-3799

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Non-Pharmacy Dispensing Site 332900000X 2625726 Minnesota

Profile Details

NPI number 1487891768
LBN Legal business name Fairview Pharmacy Services Llc
DBA Doing business as Fairview Eden Prairie Clinic Mtm
Authorized official Fasching, David
Entity Organization
Organization subpart 1 No
Enumeration date Jan 8th, 2009
Last updated Mar 16th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487891768 NPPES
Minnesota MEDICAID 226074300

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