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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
1332H00000XEyewear SupplierD7089CA

General Provider Information

NPI Number : 1366832404
Entity Type Code : Organization
Provider Name (Legal Business Name) : COSTCO WHOLESALE CORPORATION
Provider Business Mailing Address
First Line : PO BOX 35005
Second Line :
City : SEATTLE
State : WA
Zip : 98124-3405
Country : US
Telephone Number : 425-313-8100
Fax Number : 425-313-6922
Provider Business Practice Location Address
First Line : 650 GATEWAY CENTER DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-4530
Country : US
Telephone Number : 619-358-2303
Fax Number : 619-358-2305
Authorized Official
Title or Position : AVP OPTICAL
Name : ART SALAS
Credential :
Telephone Number : 619-358-2303
Provider Enumeration Date : 01/28/2015
Last Update Date : 06/05/2020

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Directions to “COSTCO WHOLESALE CORPORATION ” Practice Location

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