=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912182726
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COSTCO WHOLESALE CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/31/2007
-----------------------------------------------------
Last Update Date | 05/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5885 BARNES RD
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80922
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-591-3009
-----------------------------------------------------
Fax | 719-591-3006
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 34300
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98124-1300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-313-6670
-----------------------------------------------------
Fax | 425-313-6595
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SVP PHARMACY
-----------------------------------------------------
Name | RICHARD STEPHENS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 425-313-8259
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PDO.0000000719
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------