NPIMap

Organization Active NPI

Haggen Opco North LLC

  • Community/Retail Pharmacy
  • Tigard, OR
National Provider Identifier
1366499824
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
0001617 Issued in OR
Legal business name
HAGGEN OPCO NORTH LLC
Practice address
14300 SW Barrow Rd
Tigard, OR 97223
Phone
(503) 590-4697
Fax
(503) 590-3804
NPI assigned
May 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gaetano Dipasqua
Title
Corporate Senior Vice President, PH
Phone
(360) 650-8204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 0001617 OR Primary

Addresses

Primary practice location

14300 SW Barrow Rd
Tigard, OR 97223

Mailing address

2211 Rimland Dr
Ste 300
Bellingham, WA 98226-5664
Phone (360) 733-8720

Other identifiers 1

IdentifierTypeStateIssuer
2151119OtherPK

Other names 1

  • Haggen Pharmacy #2074 Doing business as

National Provider Directory

National Provider Directory

Member of 7

Organizations this organization is a member of, according to the National Provider Directory.

Locations

14300 SW Barrows Rd
Tigard, OR 97223
Phone (503) 590-0411

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428364800000",
    "number": "1366499824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 RIMLAND DR",
            "address_2": "STE 300",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982265664",
            "telephone_number": "360-733-8720",
            "fax_number": "360-752-6437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 SW BARROW RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97223",
            "telephone_number": "503-590-4697",
            "fax_number": "503-590-3804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAGGEN OPCO NORTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2015-04-07",
        "status": "A",
        "authorized_official_last_name": "DIPASQUA",
        "authorized_official_first_name": "GAETANO",
        "authorized_official_title_or_position": "CORPORATE SENIOR VICE PRESIDENT, PH",
        "authorized_official_telephone_number": "360-650-8204"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "0001617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2151119",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haggen Pharmacy #2074",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.