Target Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

8486 Issued in GA

Legal business name

TARGET CORPORATION

Practice address

3935 Venture Dr
Duluth, GA 30096-5078

Phone

(770) 476-9656

Fax

(770) 476-9656

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

Locations

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": "1992727556",
    "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": "3935 VENTURE DR",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965078",
            "telephone_number": "770-476-9656",
            "fax_number": "770-476-9656"
        }
    ],
    "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": "GA",
            "license": "8486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2020675",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00862089C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TARGET PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• SWL Dental
• Mikala Elizabeth Swope
• Yunhee Elyana Sym, LMFT
• Badrashila Tailor, OTR/L
• Marianna Tanner, RBT
• Angela Gail Tate, MCD/CCC-SLP
• Abbey Taylor
• Janyna Taylor, CNA
• Kaylee Coopersmith Taylor, LPC
• Madison Taylor

• Community/Retail Pharmacy in Duluth, GA
• Providers in Duluth, GA by specialty
• Community/Retail Pharmacy in Georgia

• 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.