Organization
COSTCO WHOLESALE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD STEPHENS (SVP PHARMACY)
(425) 313-8259
Entity
Organization
Contact information
Practice address
3220 N RESERVE ST, MISSOULA, MT 59808
(406) 542-3807
(406) 542-3692
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
738
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000220286
—
MT
01
—
2705020
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/30/2006
Last updated
05/22/2025
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