Target Corporation and Subsidiaries

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH0011543 Issued in FL

Legal business name

TARGET CORPORATION AND SUBSIDIARIES

Doing business as

Target Pharmacy

Practice address

6411 Tacoma Dr
Port Richey, FL 34668-4555

Phone

(727) 841-7877

Fax

(727) 841-7877

NPI assigned

Jul 24, 2006

Last updated

Sep 15, 2008By the provider in NPPES

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

Locations

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": "1316969926",
    "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": "6411 TACOMA DR",
            "city": "PORT RICHEY",
            "state": "FL",
            "postal_code": "346684555",
            "telephone_number": "727-841-7877",
            "fax_number": "727-841-7877"
        }
    ],
    "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH0011543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1066605",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101170700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TARGET PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jason L Swerdloff, MD
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• Community/Retail Pharmacy in Port Richey, FL
• Providers in Port Richey, FL by specialty
• Community/Retail Pharmacy in Florida

• 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.