Organization
HAGGEN OPCO NORTH LLC
Active
Other names
Haggen Pharmacy #2074
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
14300 SW BARROW RD, TIGARD, OR 97223
(503) 590-4697
(503) 590-3804
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
0001617
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2151119
PK
—
Enumeration date
05/30/2006
Last updated
04/07/2015
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