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General NPI Number Information
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NPI Number | 1194165910
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Entity Type | Organization
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Legal Business Name | TARGET
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Dates
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Enumeration Date | 06/25/2013
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Last Update Date | 06/25/2013
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Provider Practice Location Address
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Address Line | 1212 BRIDFORD PKWY
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City | GREENSBORO
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State | NC
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Zip | 27407-2645
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Country | US
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Telephone | 336-856-1298
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Fax |
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Provider Business Mailing Address
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Address Line | 1212 BRIDFORD PKWY
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City | GREENSBORO
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State | NC
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Zip | 27407-2645
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DISTRICT MANAGER
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Name | SHEA MANIGO
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Credential |
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Telephone | 843-425-5751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 23265
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License Number State | NC
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