Organization
COSTCO WHOLESALE CORPORATION
Active
Other names
Costco Pharmacy #628
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD STEPHENS (SVP PHARMACY)
(425) 313-8259
Entity
Organization
Contact information
Practice address
950 PORT WASHINGTON RD, GRAFTON, WI 53024
(262) 204-1059
(262) 204-1056
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
8771
WI
Other
Enumeration date
07/26/2007
Last updated
02/07/2024
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