Costco Wholesale Corporation
Organization Active NPI Community/Retail Pharmacy · Riverbank, CA
NPI 1427817469 · NPPES record last updated May 24, 2024
Key facts
- NPI
- 1427817469
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- COSTCO WHOLESALE CORPORATION
- Practice address
- 2015 Claribel Road
Riverbank, CA 95357-9001 - Phone
- (209) 458-5597
- Fax
- (209) 458-5588
- NPI assigned
- Mar 13, 2024
- Organization subpart
- No
Authorized official
- Name
- Richard Stephens, RPH
- Title
- SVP Pharmacy
- Phone
- (425) 313-8259
Corporate family (same tax ID) 24
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
- Tax ID family
- Costco Pharmacy 302
Locations
2015 Claribel Rd
Riverbank, CA 95367
Phone (209) 458-5597
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
2015 Claribel Road
Riverbank, CA 95357-9001
Mailing address
PO Box 34300
Seattle, WA 98124-1300
Phone (425) 416-2829
Other names
- Costco Pharmacy 1683
Other providers in Riverbank, CA
- Mitzi Cossio
- Connor Michael Costa
- Zoey Costa
- Costco Wholesale Corporation
- Costco Wholesale Corporation
- Adriana Covarrubias
- Kalina S Cover
- Yoryanni Coyoy
- Jewels Criswell
- Brandon Crocker
All providers in Riverbank, 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 24, 2024. 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.