# COSTCO

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043635709
- **Authorized official:** PATRICK MAINS (PHARMACY MANAGER)
- **Authorized official phone:** (864) 297-2569

## Contact information

- **Practice address:** 1021 WOODRUFF RD, GREENVILLE, SC 29607-4108
- **Practice address phone:** (864) 297-2569
- **Mailing address:** 1021 WOODRUFF RD, GREENVILLE, SC 29607-4108

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | 14212 | SC | Yes |

## Other

- **Enumeration date:** 03/04/2014
- **Last updated:** 03/04/2014