# COSTCO WHOLESALE CORPORATION

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

## Provider details

- **NPI number:** 1184976508
- **Authorized official:** RICHARD STEPHENS (SVP PHARMACY)
- **Authorized official phone:** (425) 313-8259

## Contact information

- **Practice address:** 301 W WASHINGTON ST, EAST PEORIA, IL 61611
- **Practice address phone:** (309) 427-2931
- **Practice address fax:** (309) 427-2932
- **Mailing address:** 999 LAKE DR, ISSAQUAH, WA 98027-8990
- **Mailing address phone:** (425) 313-6289
- **Mailing address fax:** (425) 313-6595

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 054018048 | IL | Yes |

## Other

- **Enumeration date:** 10/09/2012
- **Last updated:** 05/20/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1487417 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |
| 01 | — | 2137371 | PK | — |