Healthcare Provider Details

I. General information

NPI: 1386754901
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: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 SE OLDHAM PKWY
LEES SUMMIT MO
64081-2986
US

IV. Provider business mailing address

PO BOX 34300
SEATTLE WA
98124-1300
US

V. Phone/Fax

Practice location:
  • Phone: 816-272-2546
  • Fax: 816-272-1107
Mailing address:
  • Phone: 425-313-6670
  • Fax: 425-313-6595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2001000061
License Number StateMO

VIII. Authorized Official

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