Organization
COSTCO WHOLESALE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD STEPHENS (SVP PHARMACY)
(425) 313-8259
Entity
Organization
Contact information
Practice address
301 W WASHINGTON ST, EAST PEORIA, IL 61611
(309) 427-2931
(309) 427-2932
Mailing address
999 LAKE DR, ISSAQUAH, WA 98027-8990
(425) 313-6289
(425) 313-6595
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054018048
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487417
NCPDP PROVIDER IDENTIFICATION NUMBER
—
01
—
2137371
PK
—
Enumeration date
10/09/2012
Last updated
05/20/2025
Update your record
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