Costco

Primary specialty

PharmacyTaxonomy code 333600000X

License

019962 Issued in NY

Legal business name

COSTCO

Practice address

50 Overlook Blvd
Nanuet, NY 10954-5290

Phone

(845) 364-4219

Fax

(845) 425-2679

NPI assigned

Nov 24, 2014

Last updated

Nov 24, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leonard Kanchugar

Title

RPH

Phone

(845) 364-4219

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416787200000",
    "number": "1457758195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CHIPPEWA CT",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014111",
            "telephone_number": "845-357-1449",
            "fax_number": "845-425-2679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 OVERLOOK BLVD",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109545290",
            "telephone_number": "845-364-4219",
            "fax_number": "845-425-2679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTCO",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-24",
        "last_updated": "2014-11-24",
        "status": "A",
        "authorized_official_last_name": "KANCHUGAR",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "RPH",
        "authorized_official_telephone_number": "845-364-4219"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "019962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy in Nanuet, NY
• Providers in Nanuet, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; 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.