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General NPI Number Information
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NPI Number | 1558587774
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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 | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4390 MONTGOMERY RD
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-6068
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Country | US
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Telephone | 410-203-1171
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Fax | 410-203-1171
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Provider Business Mailing Address
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Address Line | 4390 MONTGOMERY RD
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-6068
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Country | US
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Telephone | 410-203-1171
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Fax | 410-203-1171
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | DR. DARSHNA PATEL
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Credential |
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Telephone | 410-203-1171
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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 | 15399
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License Number State | MD
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