Provider Demographics
NPI:1346453453
Name:TARGET MICROSYSTEMS, INC.
Entity Type:Organization
Organization Name:TARGET MICROSYSTEMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:RIDGEWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-928-2276
Mailing Address - Street 1:115 AULD RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:OH
Mailing Address - Zip Code:43025-9594
Mailing Address - Country:US
Mailing Address - Phone:740-928-2276
Mailing Address - Fax:740-928-2883
Practice Address - Street 1:115 AULD RIDGE WAY
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:OH
Practice Address - Zip Code:43025-9594
Practice Address - Country:US
Practice Address - Phone:740-928-2276
Practice Address - Fax:740-928-2883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2161940Medicaid