Organization
COSTCO WHOLESALE CORPORATION
Active
Other names
Costco Pharmacy #1159
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD STEPHENS (SVP PHARMACY)
(425) 313-8259
Entity
Organization
Contact information
Practice address
3700 S GRANGE AVE, SIOUX FALLS, SD 57105
(605) 988-9150
(605) 988-9141
Mailing address
PO BOX 34300, SEATTLE, WA 98124-1300
(425) 416-2660
(425) 313-6595
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
100-1989
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2141574
PK
—
Enumeration date
08/02/2013
Last updated
03/19/2024
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