Costco Wholesale Corporation
Organization Active NPI Community/Retail Pharmacy · Boston Heights, OH
NPI 1114390671 · NPPES record last updated May 20, 2025
Key facts
- NPI
- 1114390671
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- RTPC.022618850-03 (OH)
- Legal business name
- COSTCO WHOLESALE CORPORATION
- Practice address
- 6720 Bass Pro Rd
Boston Heights, OH 44236 - Phone
- (330) 341-7010
- Fax
- (330) 341-7001
- NPI assigned
- Nov 5, 2015
- Organization subpart
- No
Authorized official
- Name
- Richard Stephens
- Title
- SVP Pharmacy
- Phone
- (425) 313-8259
Corporate family (same tax ID) 14
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080820000449 | TX | Part B Supplier - Centralized Flu Biller | 4082679451 | This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Costco Pharmacy 302
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | RTPC.022618850-03 | OH | Yes |
Addresses
Primary practice location
6720 Bass Pro Rd
Boston Heights, OH 44236
Mailing address
PO Box 34300
Seattle, WA 98124-1300
Phone (425) 416-5259
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2159814 | Other | PK |
Other providers in Boston Heights, OH
- Denise Burr
- Costco Wholesale Corporation
- Costco Wholesale Corporation
- Jaskaran Singh Dhillon
- Sean Hughes
- Samantha Humphrey
- Robert Amos Lohman I
All providers in Boston Heights, OH · Community/Retail Pharmacy in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.