Costco Wholesale Corporation
Pharmacy, Community/Retail Pharmacy in West Bountiful, UT. Organization (NPI-2).
NPI number1619087244
StatusActive
Last updated in NPPESMay 21, 2025
Details
- NPI
- 1619087244
- Entity type
- Organization (NPI-2)
- Legal business name
- Costco Wholesale Corporation
- Organization subpart
- No
- Enumeration date
- Aug 30, 2006
- Certification date
- May 21, 2025
- Last updated
- May 21, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 60392771703 | UT | Yes |
Practice location
573 W 100 NWest Bountiful, UT 84010
Phone 801-299-3968 · Fax 801-299-3965
Mailing address
Po Box 34300Seattle, WA 98124-1300
Phone 425-313-6670 · Fax 425-313-6595
Authorized official
Richard Stephens
Svp Pharmacy
4253138259
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