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NPI Code Detail

MEDICARE: TARGET PHARMACY

MEDICARE: TARGET PHARMACY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy183500000XMN

General Provider Information

NPI Number : 1194100214
Entity Type Code : Organization
Provider Name (Legal Business Name) : TARGET PHARMACY
Provider Business Mailing Address
First Line : 4736 GRAND AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55419-5430
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2500 E LAKE ST
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-1909
Country : US
Telephone Number : 612-721-1611
Fax Number :
Authorized Official
Title or Position : HEALTHCARE BUSINESS PARTNER
Name : MELISSA NORD
Credential :
Telephone Number : 612-220-6101
Provider Enumeration Date : 07/30/2015
Last Update Date : 07/30/2015

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Directions to “TARGET PHARMACY ” Practice Location

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