Organization
COSTCO WHOLESALE CORPORATION
Active
Other names
Costco Pharmacy #641
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD STEPHENS (SVP)
(425) 313-8259
Entity
Organization
Contact information
Practice address
4301 W WILLIAM CANNON DR, AUSTIN, TX 78749
(512) 382-3020
(512) 382-3017
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
25037
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4541163
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/30/2006
Last updated
05/14/2024
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