Organization · NPI-2

Costco Wholesale Corporation

Pharmacy, Community/Retail Pharmacy · Rockwall, TX

NPI number1649410200
StatusActive
Last updated in NPPESMay 14, 2024

Details

NPI
1649410200
Entity type
Organization (NPI-2)
Legal business name
Costco Wholesale Corporation
Organization subpart
No
Enumeration date
Feb 23, 2009
Certification date
May 14, 2024
Last updated
May 14, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail Pharmacy26343TXYes

Other names

  • Costco Pharmacy # 1049 (Doing Business As)

Practice location

1225 State Highway 276
Rockwall, TX 75032-9376

Phone 972-772-1609 · Fax 972-772-1606

Mailing address

Po Box 34300
Seattle, WA 98124-1300

Phone 425-313-6670 · Fax 425-313-6595

Authorized official

Richard Stephens
Svp
4253138259

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