# COSTCO

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

## Provider details

- **NPI number:** 1366827933
- **Authorized official:** BETTY MAI PHARMD (PHARMACIST)
- **Authorized official phone:** (301) 644-1482

## Contact information

- **Practice address:** 10 MONOCACY BLVD, FREDERICK, MD 21704-7256
- **Practice address phone:** (301) 644-1482
- **Mailing address:** 10 MONOCACY BLVD, FREDERICK, MD 21704-7256

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1835P0018X | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | — | NULL | Yes |
| 1835P0018X | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | — | — | Yes |
| 261QP0905X | State or Local Public Health Clinic/Center | 22474 | MD | — |

## Other

- **Enumeration date:** 07/24/2015
- **Last updated:** 05/15/2019