Organization
COSTCO WHOLESALE CORPORATION
Active
Other names
Costco Pharmacy #1058
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD STEPHENS (SVP PHARMACY)
(425) 313-8259
Entity
Organization
Contact information
Practice address
4570 E CACTUS RD, PHOENIX, AZ 85032
(480) 308-7049
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
Y005170
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2121466
PK
—
Enumeration date
08/12/2009
Last updated
11/30/2023
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