Healthcare Provider Details

I. General information

NPI: 1467562066
Provider Name (Legal Business Name): COSTCO WHOLESALE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2270 CLOVIS AVE
CLOVIS CA
93612
US

IV. Provider business mailing address

PO BOX 35005
SEATTLE WA
98124-3405
US

V. Phone/Fax

Practice location:
  • Phone: 559-291-1084
  • Fax: 559-348-2273
Mailing address:
  • Phone: 425-313-6504
  • Fax: 425-313-6922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY40377
License Number StateCA

VIII. Authorized Official

Name: RICHARD STEPHENS
Title or Position: SVP PHARMACY
Credential:
Phone: 425-313-8259