Costco Wholesale Corporation
Organization Active NPI Community/Retail Pharmacy · Lancaster, CA
NPI 1295845808 · NPPES record last updated May 20, 2025
Key facts
- NPI
- 1295845808
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 46261 (CA)
- Legal business name
- COSTCO WHOLESALE CORPORATION
- Practice address
- 1141 W Avenue L
Lancaster, CA 93534 - Phone
- (661) 802-4469
- Fax
- (661) 802-4490
- NPI assigned
- Aug 30, 2006
- Organization subpart
- No
Authorized official
- Name
- Richard Stephens
- Title
- SVP Pharmacy
- Phone
- (425) 313-8259
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
Locations
44681 Valley Central Way
Lancaster, CA 93536
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 46261 | CA | Yes |
Addresses
Primary practice location
1141 W Avenue L
Lancaster, CA 93534
Mailing address
PO Box 34300
Seattle, WA 98124-1300
Phone (425) 313-6670
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0595528 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other providers in Lancaster, CA
- Nicole A Cortez
- Tamara Cosio
- Azize Coskun
- Adriana Costa
- Michael Costa
- Costco Wholesale Corporation
- Costco Wholesale Corporation
- Chad Costello
- Leslie Cote
- Jessica Coto
All providers in Lancaster, CA · Community/Retail Pharmacy in California
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.