Target Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH18769 Issued in FL

Legal business name

TARGET CORPORATION

Practice address

1919 Wells Rd
Orange Park, FL 32073-1701

Phone

(904) 278-3382

Fax

(904) 579-2538

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": "1376565929",
    "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": "1919 WELLS RD",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320731701",
            "telephone_number": "904-278-3382",
            "fax_number": "904-579-2538"
        }
    ],
    "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": "FL",
            "license": "PH18769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025677300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2014960",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TARGET PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hoorieh Sadat Tahami
• Kendall Alexander Talley, DO
• Tandem Health Care of Orange Park, Inc.
• Deborah Tanzuaco
• Adam Aghyad Tarboush, DMD
• Jennifer A Tarvis, FNP
• Te'Anna Tatum
• Bradley Neal Taylor, ARNP
• Devonia Taylor
• Joshua Ray Taylor, ARNP, CRNA

• Community/Retail Pharmacy in Orange Park, FL
• Providers in Orange Park, 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 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.