Organization
COSTCO WHOLESALE CORPORATION
Active
Other names
Costco Pharmacy #1019
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD STEPHENS (AVP - PHARMACY SERVICES)
(425) 313-8259
Entity
Organization
Contact information
Practice address
3571 W 10400 SOUTH, SOUTH JORDAN, UT 84095
(801) 523-5297
(801) 523-5288
Mailing address
PO BOX 34300, SEATTLE, WA 98124-1300
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
9112581-1703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146661
PK
—
Enumeration date
06/25/2014
Last updated
05/27/2025
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