Organization
HAGGEN OPCO NORTH LLC
Active
Other names
HAGGEN PHARMACY #103
Organization subpart
No
Provider details
NPI number
Authorized official
GAETANO DIPASQUA (CORPORATE SENIOR VICE PRESIDEN)
(360) 650-8204
Entity
Organization
Contact information
Practice address
1128 N MILLER ST, WENATCHEE, WA 98801-1541
(509) 662-2942
(509) 665-9170
Mailing address
2211 RIMLAND DR, SUITE 300, BELLINGHAM, WA 98226-5664
(360) 733-8720
(360) 752-6437
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.60534402
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2150297
PK
—
Enumeration date
05/25/2006
Last updated
04/01/2015
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