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General NPI Number Information
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NPI Number | 1396019899
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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 | 02/29/2012
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 10 CROOKED RUN PLZ 2297
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City | FRONT ROYAL
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State | VA
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Zip | 22630-7004
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Country | US
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Telephone | 540-631-3291
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Fax |
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Provider Business Mailing Address
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Address Line | 10 CROOKED RUN PLZ
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City | FRONT ROYAL
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State | VA
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Zip | 22630-7004
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Country | US
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Telephone | 540-631-3291
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | MS. KATIE REESE
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Credential |
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Telephone | 540-631-3291
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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 | 0202011587
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License Number State | VA
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