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General NPI Number Information
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NPI Number | 1043605983
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Entity Type | Organization
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Legal Business Name | COSTCO WHOLESALE CORPORATION
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Dates
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Enumeration Date | 03/30/2015
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Last Update Date | 06/05/2020
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Provider Practice Location Address
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Address Line | 801 TIOGA AVE
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City | SAND CITY
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State | CA
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Zip | 93955-3050
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Country | US
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Telephone | 831-899-9991
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Fax | 831-899-8503
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Provider Business Mailing Address
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Address Line | PO BOX 35005
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City | SEATTLE
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State | WA
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Zip | 98124-3405
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Country | US
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Telephone | 425-313-8100
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Fax | 425-313-6922
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Authorized Official
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Title or Position | AVP OPTICAL
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Name | ART SALAS
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Credential |
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Telephone | 318-999-9918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | D6361
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License Number State | CA
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