Organization
HAGGEN OPCO NORTH LLC
Active
Other names
Haggen Pharmacy #2087
Organization subpart
No
Provider details
NPI number
Authorized official
GAETANO DIPASQUA (CORP SENIOR VICE PRESIDENT, PHARMAC)
(360) 650-8204
Entity
Organization
Contact information
Practice address
61155 S HWY 97, BEND, OR 97702-2523
(541) 382-5742
(541) 317-4608
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
0002417
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2152383
PK
—
Enumeration date
06/22/2007
Last updated
06/10/2015
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