Organization · NPI-2

Costco Wholesale Corporation

Pharmacy, Community/Retail Pharmacy · Moreno Valley, CA

NPI number1982714580

StatusActive

Last updated in NPPESMay 20, 2025

Details

NPI: 1982714580
Entity type: Organization (NPI-2)
Legal business name: Costco Wholesale Corporation
Organization subpart: No
Enumeration date: Aug 30, 2006
Certification date: May 20, 2025
Last updated: May 20, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
3336C0003X	Pharmacy, Community/Retail Pharmacy	PHY41821	CA	Yes

Practice location

12700 Day St
Moreno Valley, CA 92553

Phone 951-697-7737 · Fax 951-697-7741

Mailing address

Po Box 34300
Seattle, WA 98124-1300

Phone 425-313-6670 · Fax 425-313-6595

Authorized official

Richard Stephens
Svp Pharmacy
4253138259

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