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General NPI Number Information
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NPI Number | 1316290026
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Entity Type | Organization
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Legal Business Name | TARGET PHARMACY
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Dates
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Enumeration Date | 10/18/2012
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Last Update Date | 10/18/2012
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Provider Practice Location Address
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Address Line | 1910 SUSSEX AVE
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City | CHERRY HILL
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State | NJ
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Zip | 08003
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Country | US
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Telephone | 856-745-2616
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Fax |
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Provider Business Mailing Address
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Address Line | 1910 SUSSEX AVE
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City | CHERRY HILL
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State | NJ
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Zip | 08003-3722
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Country | US
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Telephone | 856-745-2616
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. LINDA A MATTIOLI
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Credential | PHARMACIST
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Telephone | 856-317-1445
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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 | 28R101715100
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License Number State | NJ
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