Target Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

7361042 Issued in WI

Legal business name

TARGET CORPORATION

Doing business as

Target Pharmacy

Practice address

3535 Tower Ave
Superior, WI 54880-5334

Phone

(715) 392-9876

Fax

(715) 392-9876

NPI assigned

Jul 24, 2006

Last updated

Feb 2, 2015By 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

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

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan M Paine, RPH

  • Pharmacist
  • Superior, WI
  • NPI 1629363478
  NPD (past)
• James Francis Sheahan Jr.

  • Pharmacist
  • Superior, WI
  • NPI 1053605121
  NPD (past)
• Thomas J Sitek

  • Pharmacist
  • Superior, WI
  • NPI 1659665735
  NPD (past)

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": "1568484269",
    "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": "3535 TOWER AVE",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548805334",
            "telephone_number": "715-392-9876",
            "fax_number": "715-392-9876"
        }
    ],
    "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": "WI",
            "license": "7361042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2115371",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33198000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TARGET PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Superior Wi Management, LLC (Superior Nursing and Rehabilitation Center)
• Kristine M Swan, MFT-IT
• John Michael Swanson, MA CCC/SLP
• Lauren Swanson
• David X Swenson, PHD, LP
• Michelle Tavera, DPT
• Taylor McClung Psychotherapy PLLC
• Amber Lee Tenerelli, DPT
• Olga Mikhaylovna Ter-Grigoryan
• Rodneyt Tester

• Community/Retail Pharmacy in Superior, WI
• Providers in Superior, WI by specialty
• Community/Retail Pharmacy in Wisconsin

• 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.