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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 SupplierOE864FL

General Provider Information

NPI Number : 1689068553
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 : 4901 GATE PKWY
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32246-4405
Country : US
Telephone Number : 904-997-7003
Fax Number : 904-997-7005
Authorized Official
Title or Position : AVP OPTICAL
Name : ART SALAS
Credential :
Telephone Number : 904-997-7003
Provider Enumeration Date : 03/27/2015
Last Update Date : 06/04/2020

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Directions to “COSTCO WHOLESALE CORPORATION ” Practice Location

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