NPIMap

Organization Active NPI

Costco Wholesale Corporation

Doing business as Costco Optical #691

  • Eyewear Supplier
  • Avondale, AZ
National Provider Identifier
1104216258
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
942E Issued in AZ
Legal business name
COSTCO WHOLESALE CORPORATION
Doing business as
Costco Optical #691
Practice address
10000 W McDowell Rd
Avondale, AZ 85392-4803
Phone
(623) 907-5661
Fax
(623) 907-5680
NPI assigned
Jan 28, 2015
Last updated
Jun 11, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
COSTCO WHOLESALE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Art Salas
Title
Avp Optical
Phone
(623) 907-5661

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 942E AZ Primary

Addresses

Primary practice location

10000 W McDowell Rd
Avondale, AZ 85392-4803

Mailing address

PO Box 35005
Seattle, WA 98124-3405
Phone (425) 313-8100

Other names 1

  • Costco Optical #691 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Costco Pharmacy 1801,511 organizations share this tax ID, including this one
Part of
Costco Pharmacy 180

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1104216258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35005",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981243405",
            "telephone_number": "425-313-8100",
            "fax_number": "425-313-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W MCDOWELL RD",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853924803",
            "telephone_number": "623-907-5661",
            "fax_number": "623-907-5680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTCO WHOLESALE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COSTCO WHOLESALE CORPORATION",
        "enumeration_date": "2015-01-28",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "SALAS",
        "authorized_official_first_name": "ART",
        "authorized_official_title_or_position": "AVP OPTICAL",
        "authorized_official_telephone_number": "623-907-5661"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "AZ",
            "license": "942E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Costco Optical #691",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Costco Optical #691",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Avondale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.