Target Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

201003445 Issued in VA

Legal business name

TARGET CORPORATION

Doing business as

TARGET PHARMACY

Practice address

8340 Sudley Rd
Manassas, VA 20109-3428

Phone

(703) 392-3634

Fax

(703) 334-0339

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

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Leigh Harless

  • Pharmacist
  • Manassas, VA
  • NPI 1356627541
  NPD (past)
• NA-Young Kim

  • Pharmacist
  • Manassas, VA
  • NPI 1962799866
  NPD (past)
• Leonard Ellis Wryter, PHARMD

  • Pharmacist
  • Manassas, VA
  • NPI 1295022275
  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": "1881616563",
    "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": "8340 SUDLEY RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201093428",
            "telephone_number": "703-392-3634",
            "fax_number": "703-334-0339"
        }
    ],
    "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": "VA",
            "license": "201003445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8512311",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2107253",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TARGET PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Talako Industries
• Ruksana Talaksi, DDS
• Andrea Taliaferro, M.S.
• Taras Techniques, LLC
• Jarid A Tareen, MD
• Shawal Tariq, NP
• Sarah Grace Tartabini, PA-C
• Tanarrah Tate
• Nicholas J Tavani, MD
• Rafik Tawdrose

• Community/Retail Pharmacy in Manassas, VA
• Providers in Manassas, VA by specialty
• Community/Retail Pharmacy in Virginia

• 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.