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NPI Code Detail

MEDICARE: COSTCO WHOLESALE CORPORATION

MEDICARE: COSTCO WHOLESALE CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail PharmacyPHY41403CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10554142OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number : 1316057912
Entity Type Code : Organization
Provider Name (Legal Business Name) : COSTCO WHOLESALE CORPORATION
Provider Business Mailing Address
First Line : PO BOX 34300
Second Line :
City : SEATTLE
State : WA
Zip : 98124-1300
Country : US
Telephone Number : 425-313-6670
Fax Number : 425-313-6595
Provider Business Practice Location Address
First Line : 1900 DAVIS ST
Second Line :
City : SAN LEANDRO
State : CA
Zip : 94577-1209
Country : US
Telephone Number : 510-562-6815
Fax Number : 510-562-5194
Authorized Official
Title or Position : AVP PHARMACY
Name : RICHARD STEPHENS
Credential :
Telephone Number : 425-313-8259
Provider Enumeration Date : 08/30/2006
Last Update Date : 05/23/2025

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Directions to “COSTCO WHOLESALE CORPORATION ” Practice Location

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