Healthcare Provider Details

I. General information

NPI: 1750061008
Provider Name (Legal Business Name): COSTCO WHOLESALE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2023
Last Update Date: 11/24/2023
Certification Date: 11/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 NEWPARK MALL
NEWARK CA
94560-5201
US

IV. Provider business mailing address

PO BOX 34300
SEATTLE WA
98124-1300
US

V. Phone/Fax

Practice location:
  • Phone: 510-493-2955
  • Fax: 510-493-2946
Mailing address:
  • Phone: 425-416-1294
  • Fax: 425-313-6595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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