Target Medical, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0000001104 Issued in TN

Legal business name

TARGET MEDICAL, INC.

Practice address

2158 Heyde Av
Ste 7
Memphis, TN 38114-4840

Phone

(901) 323-1304

Fax

(901) 323-1275

NPI assigned

Mar 7, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Thomas R Brockway Sr.

Title

President

Phone

(901) 323-1304

Specialties & licenses 3

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331078400000",
    "number": "1720055908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2158 HEYDE AV",
            "address_2": "STE 7",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381144840",
            "telephone_number": "901-323-1304",
            "fax_number": "901-323-1275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2158 HEYDE AV",
            "address_2": "STE 7",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381144840",
            "telephone_number": "901-323-1304",
            "fax_number": "901-323-1275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARGET MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-07",
        "last_updated": "2012-03-07",
        "status": "A",
        "authorized_official_last_name": "BROCKWAY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-323-1304",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "0000001104",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "04203 / 11.1",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AR",
            "license": "MG01258",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TLC   HME/DME PROVIDER",
            "identifier": "20077",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY - SUPPLIER OF MEDICAL EQUIPMENT, & MEDICAL GAS PERMIT",
            "identifier": "MG01258",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452059",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TCS/BCBS  HME/DME PROVIDR",
            "identifier": "3008232",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kristine J Tarbell, OT
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• Lisa Maria Tartaglia, D.O.
• Sondra Cecile Tashie, PHARMD
• Kendra Tate-Blaylock
• Angela Tate, OT
• Ariyan Nicole Cox Tate, MD

• Durable Medical Equipment & Medical Supplies in Memphis, TN
• Providers in Memphis, TN by specialty
• Durable Medical Equipment & Medical Supplies in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; 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.