NPIMap

Organization Active NPI

Haggen Opco North LLC

Doing business as Haggen Pharmacy #2087

  • Community/Retail Pharmacy
  • Bend, OR
National Provider Identifier
1467658864
Registry record updated Jun 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
0002417 Issued in OR
Legal business name
HAGGEN OPCO NORTH LLC
Doing business as
Haggen Pharmacy #2087
Practice address
61155 S Hwy 97
Bend, OR 97702-2523
Phone
(541) 382-5742
Fax
(541) 317-4608
NPI assigned
Jun 22, 2007
Last updated
Jun 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2015

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

Authorized official

Name
Gaetano Dipasqua
Title
Corp Senior Vice President, Pharmac
Phone
(360) 650-8204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 0002417 OR Primary

Addresses

Primary practice location

61155 S Hwy 97
Bend, OR 97702-2523

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
2152383OtherPK

Other names 1

  • Haggen Pharmacy #2087 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.

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433894400000",
    "number": "1467658864",
    "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": "61155 S HWY 97",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022523",
            "telephone_number": "541-382-5742",
            "fax_number": "541-317-4608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAGGEN OPCO NORTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2015-06-10",
        "status": "A",
        "authorized_official_last_name": "DIPASQUA",
        "authorized_official_first_name": "GAETANO",
        "authorized_official_title_or_position": "CORP SENIOR VICE PRESIDENT, PHARMAC",
        "authorized_official_telephone_number": "360-650-8204"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "0002417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2152383",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haggen Pharmacy #2087",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.