# COSTCO WHOLESALE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Costco Pharmacy \#1710
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619735636
- **Authorized official:** RICHARD STEPHENS (SVP PHARMACY)
- **Authorized official phone:** (425) 313-8259

## Contact information

- **Practice address:** 310 INTEGRITY DR STE 105, MADISON, WI 53717-1416
- **Practice address phone:** (855) 213-0070
- **Practice address fax:** (855) 213-0125
- **Mailing address:** PO BOX 34300, SEATTLE, WA 98124-1300
- **Mailing address phone:** (425) 416-1294
- **Mailing address fax:** (425) 313-6595

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336M0002X | Mail Order Pharmacy | — | NULL | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 03/13/2024
- **Last updated:** 08/16/2024