Organization
COSTCO WHOLESALE CORPORATION
Active
Other names
Costco Pharmacy #1696
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD B STEPHENS (SVP PHARMACY)
(425) 313-8259
Entity
Organization
Contact information
Practice address
62207 NW COSTCO DR, BEND, OR 97703-8508
(541) 640-8582
(541) 640-8573
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
0001290
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2078301
PK
—
01
—
3811204
NCPDP IDENTIFICATION NUMBER
—
Enumeration date
08/30/2006
Last updated
10/21/2024
Update your record
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