Organization
COSTCO WHOLESALE CORPORATION
Active
Parent organization
COSTCO WHOLESALE CORPORATION
Other names
Costco Optical #455
Organization subpart
Yes
Provider details
NPI number
Legal business name
COSTCO WHOLESALE CORPORATION
Authorized official
ART SALAS (AVP OPTICAL)
(951) 697-8900
Entity
Organization
Contact information
Practice address
12700 DAY ST, MORENO VALLEY, CA 92553-7521
(951) 697-8900
(951) 697-8901
Mailing address
PO BOX 35005, SEATTLE, WA 98124-3405
(425) 313-8100
(425) 313-6922
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
D6839
CA
Other
Enumeration date
01/21/2015
Last updated
06/12/2020
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