Organization · NPI-2

Costco Wholesale Corporation

Eyewear Supplier (Equipment, not the service) · Winter Park, FL

NPI number1154715019

StatusActive

Last updated in NPPESJun 4, 2020

Details

NPI: 1154715019
Entity type: Organization (NPI-2)
Legal business name: Costco Wholesale Corporation
Organization subpart: Yes
Enumeration date: Mar 27, 2015
Certification date: Jun 4, 2020
Last updated: Jun 4, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
332H00000X	Eyewear Supplier (Equipment, not the service)	OE812	FL	Yes

Other names

Costco Optical #185 (Doing Business As)

Practice location

3333 University Blvd
Winter Park, FL 32792-7428

Phone 407-681-2105 · Fax 407-681-2108

Mailing address

Po Box 35005
Seattle, WA 98124-3405

Phone 425-313-8100 · Fax 425-313-6922

Authorized official

Art Salas
Avp Optical
4076812105

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