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NPI Code Detail

MEDICARE: TARGET

MEDICARE: TARGET
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
13336C0003XCommunity/Retail Pharmacy720810MN

General Provider Information

NPI Number : 1356618243
Entity Type Code : Organization
Provider Name (Legal Business Name) : TARGET
Provider Business Mailing Address
First Line : 7535 W BROADWAY AVE
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55428-1287
Country : US
Telephone Number : 763-425-5300
Fax Number : 763-425-5300
Provider Business Practice Location Address
First Line : 7535 W BROADWAY AVE
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55428-1287
Country : US
Telephone Number : 763-425-5300
Fax Number : 763-425-5300
Authorized Official
Title or Position : TECHNICIAN
Name : TAMMY THU VO
Credential :
Telephone Number : 763-425-5300
Provider Enumeration Date : 11/21/2011
Last Update Date : 11/21/2011

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Directions to “TARGET ” Practice Location

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