Target Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

3931 Issued in TN

Legal business name

TARGET CORPORATION

Practice address

5330 Cane Ridge Rd
Antioch, TN 37013-3839

Phone

(615) 731-1729

Fax

(615) 932-5271

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

Kimberly Jerome

Title

HC Enrollment Specialist

Phone

(612) 696-8312

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": "1422835200000",
    "number": "1366464018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NICOLLET MALL # 1795",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 CANE RIDGE RD",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133839",
            "telephone_number": "615-731-1729",
            "fax_number": "615-932-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARGET CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2015-02-02",
        "status": "A",
        "authorized_official_last_name": "JEROME",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "HC ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "612-696-8312"
    },
    "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": "TN",
            "license": "3931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4436742",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2093976",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TARGET PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sulliman Transportation
• Alyse Marie Sullivan, NP
• Aren Swogger, DPT
• Samuael B Takele
• Rona Annette Talley, ND,LMT, RCR
• Justin Andrew Tatman, ATC
• Youssef Tawfik, M.D.
• Samuel Tekle
• Tennessee Dental Professionals, PC
• Tennessee Electro Neuro Diagnostics

• Community/Retail Pharmacy in Antioch, TN
• Providers in Antioch, TN by specialty
• Community/Retail Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; 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.