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
16400 STATE ROAD 54, ODESSA, FL 33556-3720
(813) 383-0011
(813) 383-0011
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
PH22254
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031743800
—
FL
01
—
2007163
PK
—
Enumeration date
10/19/2006
Last updated
01/30/2015
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