Healthcare Provider Details

I. General information

NPI: 1386767036
Provider Name (Legal Business Name): TARGET CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 NICOLLET MALL TPS-1154
MINNEAPOLIS MN
55403-2542
US

IV. Provider business mailing address

1000 NICOLLET MALL TPS-1154
MINNEAPOLIS MN
55403-2542
US

V. Phone/Fax

Practice location:
  • Phone: 612-696-2262
  • Fax:
Mailing address:
  • Phone: 612-696-2262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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