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Organization
HAGGEN OPCO NORTH LLC
Active
Organization
HAGGEN OPCO NORTH LLC
Active
Other names
Haggen Pharmacy #2081
Organization subpart
No
Provider details
NPI number
Authorized official
GAETANO DIPASQUA (CORPORATE SENIOR VICE PRESIDENT, PH)
(360) 650-8204
Entity
Organization
Contact information
Practice address
16199 BOONES FERRY RD, LAKE OSWEGO, OR 97035-4201
(503) 635-6630
(503) 635-6633
Mailing address
2211 RIMLAND DR, STE 300, BELLINGHAM, WA 98226-5664
(360) 733-8720
(360) 752-6437
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0001514
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2150942
PK
—
Enumeration date
05/25/2006
Last updated
06/11/2015
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