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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
1333600000XPharmacy
23336C0003XCommunity/Retail PharmacyRTP.021236200-03OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12077691OTHERPK

General Provider Information

NPI Number : 1861502494
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 : 7135 VETERANS BLVD
Second Line :
City : LIBERTY TOWNSHIP
State : OH
Zip : 45069-3771
Country : US
Telephone Number : 513-346-7940
Fax Number :
Authorized Official
Title or Position : SVP PHARMACY
Name : RICHARD STEPHENS
Credential :
Telephone Number : 425-313-8259
Provider Enumeration Date : 08/30/2006
Last Update Date : 11/09/2022

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Directions to “COSTCO WHOLESALE CORPORATION ” Practice Location

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