Target Corporation and Subsidiaries

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301006966 Issued in MI

Legal business name

TARGET CORPORATION AND SUBSIDIARIES

Practice address

27300 Dequindre Rd
Warren, MI 48092-2870

Phone

(586) 573-0896

Fax

(586) 573-0896

NPI assigned

Jul 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paula Ekeren

Title

Managed Care Administrator

Phone

(612) 696-2262

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• TARGET PHARMACY Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1174545842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NICOLLET MALL # 0910",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27300 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922870",
            "telephone_number": "586-573-0896",
            "fax_number": "586-573-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARGET CORPORATION AND SUBSIDIARIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "EKEREN",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "MANAGED CARE ADMINISTRATOR",
        "authorized_official_telephone_number": "612-696-2262"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301006966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2359342",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2359342",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TARGET PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sara Tandoc, NP-C
• Larry B Tankanow, MD
• Tanni Home Care LLC
• Brittany Tansil, LMSW, CADC
• Efstathios S Tapazoglou, M.D.
• Tasnia Taseed
• Frances Ann Tassen, R.D., C.D.E.
• Brandon Michael Tatar, MSN, APRN, ACCNS-AG
• Rakia Tate
• Taufic Nahhas DMD PLLC

• Community/Retail Pharmacy in Warren, MI
• Providers in Warren, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.