Costco Wholesale Corporation

Eyewear Supplier (Equipment, not the service) in Winston Salem, NC. Organization (NPI-2).

NPI number1376937425

StatusActive

Last updated in NPPESJun 5, 2020

Details

NPI: 1376937425
Entity type: Organization (NPI-2)
Legal business name: Costco Wholesale Corporation
Organization subpart: Yes
Enumeration date: Mar 26, 2015
Certification date: Jun 5, 2020
Last updated: Jun 5, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
332H00000X	Eyewear Supplier (Equipment, not the service)	1615	NC	Yes

Other names

Costco Optical #361 (Doing Business As)

Practice location

1085 Hanes Mall Blvd
Winston Salem, NC 27103-1310

Phone 336-970-2301 · Fax 336-970-2317

Mailing address

Po Box 35005
Seattle, WA 98124-3405

Phone 425-313-8100 · Fax 425-313-6922

Authorized official

Art Salas
Avp Optical
3369702301

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