NPIMap

Organization Active NPI

Target Store #T-0852

  • Pharmacist
  • Rohnert Park, CA
National Provider Identifier
1336246776
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
57165 Issued in CA
Legal business name
TARGET STORE #T-0852
Practice address
475 Rohnert Park Expy W
Rohnert Park, CA 94928-7907
Phone
(707) 585-2420
Fax
(707) 585-2420
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Julie Days, PHARMD
Title
Pharmacy Manager
Phone
(707) 585-2420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 57165 CA Primary

Addresses

Primary practice location

475 Rohnert Park Expy W
Rohnert Park, CA 94928-7907

Mailing address

475 Rohnert Park Expy W
Rohnert Park, CA 94928-7907
Phone (707) 585-2420

Other identifiers 1

IdentifierTypeStateIssuer
PHA468430OtherCAMEDI-CAL PROVIDER #

National Provider Directory

National Provider Directory
Tax ID family
Target33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

Locations

475 Rohnert Park Expy W
Rohnert Park, CA 94928
Phone (707) 585-2420

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336246776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 ROHNERT PARK EXPY W",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949287907",
            "telephone_number": "707-585-2420",
            "fax_number": "707-585-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 ROHNERT PARK EXPY W",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949287907",
            "telephone_number": "707-585-2420",
            "fax_number": "707-585-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARGET STORE #T-0852",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAYS",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "707-585-2420",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "57165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROVIDER #",
            "identifier": "PHA468430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rohnert Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.