Healthcare Provider Details

I. General information

NPI: 1528276342
Provider Name (Legal Business Name): TARGET CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4647 PROMENADE WAY RELO 0869
MATTESON IL
60443-2981
US

IV. Provider business mailing address

1000 NICOLLET MALL ATTN PHARMACY MANAGED CARE
MINNEAPOLIS MN
55403-2542
US

V. Phone/Fax

Practice location:
  • Phone: 708-898-5009
  • Fax: 708-898-5009
Mailing address:
  • Phone: 612-696-2262
  • Fax: 612-696-0859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: PAULA EKEREN
Title or Position: MANAGED CARE ADMIN
Credential:
Phone: 612-696-2262