Costco Wholesale Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P05362 Issued in MD

Legal business name

COSTCO WHOLESALE CORPORATION

Practice address

2400 Five Lees LN
Glenarden, MD 20706

Phone

(301) 341-6749

Fax

(301) 341-6746

NPI assigned

Sep 10, 2010

Organization subpart

No

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

Authorized official

Name

Richard Stephens

Title

SVP Pharmacy

Phone

(425) 313-8259

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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

{
    "created_epoch": "1284076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1295042315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241300",
            "telephone_number": "425-313-6670",
            "fax_number": "425-313-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 FIVE LEES LN",
            "city": "GLENARDEN",
            "state": "MD",
            "postal_code": "20706",
            "telephone_number": "301-341-6749",
            "fax_number": "301-341-6746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTCO WHOLESALE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-10",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "SVP PHARMACY",
        "authorized_official_telephone_number": "425-313-8259"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P05362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2135425",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charlyne Cole
• Taylor A Coleman
• Elizabeth Coll
• Cynthia Leonor Contreras
• Costco Wholesale Corporation
• Costco Wholesale Corporation
• Courtney S Palmer DPM
• Omolara Durojaiye
• Coritha Mesang Esoh Ebage
• Geraldine Obioma Ehirim

• Community/Retail Pharmacy in Glenarden, MD
• Providers in Glenarden, MD by specialty
• Community/Retail Pharmacy in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.