Organization
COSTCO WHOLESALE CORPORATION
Active
Other names
Costco Pharmacy #693
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD STEPHENS (SVP)
(425) 313-8259
Entity
Organization
Contact information
Practice address
1201 N LOOP 1604 E, SAN ANTONIO, TX 78232
(210) 403-4702
(210) 403-4725
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
22181
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4523507
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/30/2006
Last updated
05/14/2024
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