Healthcare Provider Details
I. General information
NPI: 1023824000
Provider Name (Legal Business Name): COSTCO WHOLESALE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/05/2024
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
160 OLD POST ROAD
SHARON MA
02067
US
IV. Provider business mailing address
PO BOX 34300
SEATTLE WA
98124-1300
US
V. Phone/Fax
- Phone: 781-253-7650
- Fax: 781-253-7641
- Phone: 425-416-2829
- Fax: 425-313-6595
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
STEPHENS
Title or Position: SVP PHARMACY
Credential:
Phone: 425-313-8259