Organization
COSTCO WHOLESALE CORPORATION
Active
Other names
COSTCO PHARMACY # 204
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD STEPHENS (AVP PHARMACY)
(425) 313-8259
Entity
Organization
Contact information
Practice address
4725 W OX RD, FAIRFAX, VA 22030-6125
(703) 802-1229
(703) 332-3221
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
0201003261
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4829000
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/30/2006
Last updated
05/28/2025
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