1194987644 NPI number — TARGET CORPORATION AND SUBSIDIARIES

Table of content: (NPI 1194987644)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194987644 NPI number — TARGET CORPORATION AND SUBSIDIARIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TARGET CORPORATION AND SUBSIDIARIES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TARGET PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194987644
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 NICOLLET MALL
Provider Second Line Business Mailing Address:
TPS 1792
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55403-2542
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3060 PLAZA BONITA RD
Provider Second Line Business Practice Location Address:
ATTN ETL PHARMACY
Provider Business Practice Location Address City Name:
NATIONAL CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91950-8004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-791-2750
Provider Business Practice Location Address Fax Number:
619-791-2750
Provider Enumeration Date:
06/26/2008

Additional Information

Authorized Official

Authorized Official Last Name:
EKEREN
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
Authorized Official Title or Position:
MANG CARE SPEC
Authorized Official Telephone Number:
612-696-2262

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5630581 . This is a "OTHER ID NUMBER" identifier . This identifiers is of the category "OTHER".




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