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General NPI Number Information
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NPI Number | 1134500838
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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 | 06/18/2015
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 2660 PARK CENTER DR
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City | SIMI VALLEY
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State | CA
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Zip | 93065-6207
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Country | US
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Telephone | 805-578-3305
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Fax | 805-578-3309
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Provider Business Mailing Address
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Address Line | 2660 PARK CENTER DR
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City | SIMI VALLEY
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State | CA
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Zip | 93065-6207
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Country | US
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Telephone | 805-578-3305
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Fax | 805-578-3309
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT
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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 | 46620
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License Number State | CA
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