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General NPI Number Information
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NPI Number | 1568878122
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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 | 07/03/2014
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Last Update Date | 07/03/2014
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Provider Practice Location Address
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Address Line | 1717 OLENTANGY RIVER RD
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City | COLUMBUS
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State | OH
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Zip | 43212
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Country | US
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Telephone | 614-298-1078
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Fax |
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Provider Business Mailing Address
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Address Line | 5122 POLAR DR
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City | LEWIS CENTER
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State | OH
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Zip | 43035
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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 | PHARMACIST
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Name | MRS. AMANDA MARIE ANDEL
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Credential | PHARM D
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Telephone | 614-563-6641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 03325661
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License Number State | OH
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