NPIMap

Organization Active NPI

Costco

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Frederick, MD
National Provider Identifier
1366827933
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
Legal business name
COSTCO
Practice address
10 Monocacy Blvd
Frederick, MD 21704-7256
Phone
(301) 644-1482
NPI assigned
Jul 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Authorized official

Name
Betty Mai, PHARMD
Title
Pharmacist
Phone
(301) 644-1482

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 1835P0018X Primary
State or Local Public Health Clinic/Center 261QP0905X 22474 MD

Addresses

Primary practice location

10 Monocacy Blvd
Frederick, MD 21704-7256

Mailing address

10 Monocacy Blvd
Frederick, MD 21704-7256

National Provider Directory

National Provider Directory
Tax ID family
Costco3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557878400000",
    "number": "1366827933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MONOCACY BLVD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217047256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MONOCACY BLVD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217047256",
            "telephone_number": "301-644-1482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTCO",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-24",
        "last_updated": "2019-05-15",
        "status": "A",
        "authorized_official_last_name": "MAI",
        "authorized_official_first_name": "BETTY",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "301-644-1482",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "MD",
            "license": "22474",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.