Organization
COSTCO WHOLESALE CORPORATION
Active
Other names
Costco Pharmacy 773
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD B STEPHENS (SVP PHARMACY)
(425) 313-8259
Entity
Organization
Contact information
Practice address
355 E NEIDER AVE, COEUR D ALENE, ID 83815
(208) 676-7353
(208) 676-7379
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
1846CP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1307429
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/30/2006
Last updated
11/21/2023
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