Healthcare Provider Details

I. General information

NPI: 1104561570
Provider Name (Legal Business Name): COSTCO WHOLESALE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2022
Last Update Date: 05/01/2022
Certification Date: 05/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 WORLD COMMERCE PKWY
ST AUGUSTINE FL
32092-3806
US

IV. Provider business mailing address

PO BOX 35005
SEATTLE WA
98124-3405
US

V. Phone/Fax

Practice location:
  • Phone: 425-313-8100
  • Fax:
Mailing address:
  • Phone: 425-313-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: CHRISTIAN ANTHIS
Title or Position: AGMM
Credential:
Phone: 425-313-8100