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General NPI Number Information
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NPI Number | 1073895496
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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 | 09/12/2011
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 825 CABELA DR
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City | AUGUSTA
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State | GA
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Zip | 30909-8202
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Country | US
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Telephone | 706-739-1701
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Fax | 706-739-1702
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Provider Business Mailing Address
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Address Line | PO BOX 34300
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City | SEATTLE
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State | WA
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Zip | 98124-1300
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AVP PHARMACY
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Name | RICHARD STEPHENS
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Credential |
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Telephone | 425-313-8259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHRE009787
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License Number State | GA
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