NPIMap

Organization Active NPI

Costco Wholesale Corporation

  • Community/Retail Pharmacy
  • Chicago, IL
National Provider Identifier
1306107495
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054017916 Issued in IL
Legal business name
COSTCO WHOLESALE CORPORATION
Practice address
1430 S Ashland Ave
Chicago, IL 60608
Phone
(312) 492-3601
Fax
(312) 492-3602
NPI assigned
Jun 5, 2012
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Richard Stephens
Title
SVP Pharmacy
Phone
(425) 313-8259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080820000449 TX Part B Supplier - Centralized Flu Biller 4082679451 This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Costco Pharmacy 3021,506 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 054017916 IL Primary

Addresses

NPPES NPI Registry

Primary practice location

1430 S Ashland Ave
Chicago, IL 60608

Mailing address

PO Box 34300
Seattle, WA 98124-1300
Phone (425) 313-6670

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1486756OtherNCPDP PROVIDER IDENTIFICATION NUMBER

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 22, 2025.

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1306107495",
    "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": "1430 S ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60608",
            "telephone_number": "312-492-3601",
            "fax_number": "312-492-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTCO WHOLESALE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-05",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "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": "IL",
            "license": "054017916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1486756",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.