Organization
TARGET CORPORATION
Active
Other names
TARGET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY JEROME (HC ENROLLMENT SPECIALIST)
(612) 696-8312
Entity
Organization
Contact information
Practice address
8109 MALL PKWY, LITHONIA, GA 30038-2546
(678) 259-0047
(678) 259-0047
Mailing address
1000 NICOLLET MALL # 1795, MINNEAPOLIS, MN 55403-2542
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE008837
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000862089G
—
GA
01
—
2015565
PK
—
Enumeration date
07/24/2006
Last updated
02/02/2015
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