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General NPI Number Information
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NPI Number | 1548650112
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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 | 02/03/2015
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Last Update Date | 06/05/2020
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Provider Practice Location Address
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Address Line | 11260 WHITE ROCK RD
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City | RANCHO CORDOVA
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State | CA
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Zip | 95742-6571
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Country | US
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Telephone | 916-631-7594
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Fax | 916-724-2242
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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 | 916-631-7594
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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 | D6824
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License Number State | CA
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