Organization
HAGGEN OPCO NORTH LLC
Active
Other names
Haggen Pharmacy #131
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
8611 STEILACOOM BLVD SW, LAKEWOOD, WA 98498-4716
(253) 582-4149
(253) 582-8664
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
60536292
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2150793
PK
—
Enumeration date
05/25/2006
Last updated
06/10/2015
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