Active NPI
Costco Wholesale Corporation
- Community/Retail Pharmacy
- Scarborough, ME
National Provider Identifier
1326728684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- COSTCO WHOLESALE CORPORATION
- Practice address
- 455 Scarborough Downs Rd
Scarborough, ME 04074-6589 - Phone
- (207) 503-9912
- Fax
- (207) 503-9903
- NPI assigned
- Jul 21, 2023
- Organization subpart
- Yes
- Parent organization
- COSTCO WHOLESALE CORPORATION
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Richard Stephens, RPH
- Title
- SVP Pharmacy
- Phone
- (425) 313-8259
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
455 Scarborough Downs Rd
Scarborough, ME 04074-6589
Mailing address
PO Box 34300
Seattle, WA 98124-1300
Phone (425) 416-2829
Other names 1
- Costco Pharmacy 1657
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| 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
National Provider Directory- Tax ID family
- Costco Pharmacy 302
- Part of
- Costco Pharmacy 302
Organizations with this tax ID in the same state 2
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Hearing Aid Equipment
- Scarborough, ME
- NPI 1710767454
-
- Eyewear Supplier
- Scarborough, ME
- NPI 1821878562
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689897600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1700784000000",
"number": "1326728684",
"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": "425-416-2829",
"fax_number": "425-313-6595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 SCARBOROUGH DOWNS RD",
"city": "SCARBOROUGH",
"state": "ME",
"postal_code": "040746589",
"telephone_number": "207-503-9912",
"fax_number": "207-503-9903"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COSTCO WHOLESALE CORPORATION",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "COSTCO WHOLESALE CORPORATION",
"enumeration_date": "2023-07-21",
"last_updated": "2023-11-24",
"certification_date": "2023-11-24",
"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",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Costco Pharmacy 1657",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Scarborough, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2023; 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.