Organization
COSTCO WHOLESALE CORPORATION
Active
Other names
Costco Pharmacy #1020
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD STEPHENS (SVP PHARMACY)
(425) 313-8259
Entity
Organization
Contact information
Practice address
2150 DEMING WAY, MIDDLETON, WI 53562
(608) 824-3959
Mailing address
PO BOX 34300, SEATTLE, WA 98124-1300
(425) 313-6670
(425) 313-6595
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
8865-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5130858
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/26/2008
Last updated
02/07/2024
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