# COSTCO WHOLESALE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Costco Pharmacy \#1159
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750713574
- **Authorized official:** RICHARD STEPHENS (SVP PHARMACY)
- **Authorized official phone:** (425) 313-8259

## Contact information

- **Practice address:** 3700 S GRANGE AVE, SIOUX FALLS, SD 57105
- **Practice address phone:** (605) 988-9150
- **Practice address fax:** (605) 988-9141
- **Mailing address:** PO BOX 34300, SEATTLE, WA 98124-1300
- **Mailing address phone:** (425) 416-2660
- **Mailing address fax:** (425) 313-6595

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 100-1989 | SD | Yes |

## Other

- **Enumeration date:** 08/02/2013
- **Last updated:** 03/19/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2141574 | PK | — |