NPIMap

Organization Active NPI

Haggen Opco North LLC

Doing business as Haggen Pharmacy #105

  • Community/Retail Pharmacy
  • Walla Walla, WA
National Provider Identifier
1386690204
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
60534405 Issued in WA
Legal business name
HAGGEN OPCO NORTH LLC
Doing business as
Haggen Pharmacy #105
Practice address
450 N Wilbur Ave
Walla Walla, WA 99362-2254
Phone
(509) 529-3706
Fax
(509) 529-3788
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 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 60534405 WA Primary

Addresses

Primary practice location

450 N Wilbur Ave
Walla Walla, WA 99362-2254

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
2150624OtherPK

Other names 1

  • Haggen Pharmacy #105 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

450 N Wilbur Ave
Walla Walla, WA 99362
Phone (509) 529-2008

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1386690204",
    "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": "450 N WILBUR AVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622254",
            "telephone_number": "509-529-3706",
            "fax_number": "509-529-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAGGEN OPCO NORTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2015-04-01",
        "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": "WA",
            "license": "60534405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2150624",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haggen Pharmacy #105",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.