Organization
COSTCO WHOLESALE CORPORATION
Active
Other names
Costco Pharmacy #1101
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD STEPHENS (SVP PHARMACY)
(425) 313-8259
Entity
Organization
Contact information
Practice address
443 PEWAUKEE RD, PEWAUKEE, WI 53072
(262) 956-6701
(262) 956-6702
Mailing address
PO BOX 34300, SEATTLE, WA 98124
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
9098-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5132840
NCPDP
—
Enumeration date
09/12/2011
Last updated
02/07/2024
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