Organization
COSTCO WHOLESALE CORPORATION
Active
Other names
COSTCO Pharmacy # 1087
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD STEPHENS (AVP PHARMACY)
(425) 313-8259
Entity
Organization
Contact information
Practice address
14050 BURNHAVEN DR, BURNSVILLE, MN 55337-4407
(952) 229-6458
(952) 229-6455
Mailing address
PO BOX 34300, SEATTLE, WA 98124-1300
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
263612
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2430332
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/14/2010
Last updated
05/27/2025
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