NPIMap

Organization Active NPI

Costco Wholesale Corporation

  • Community/Retail Pharmacy
  • Ann Arbor, MI
National Provider Identifier
1497014757
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301009841 Issued in MI
Legal business name
COSTCO WHOLESALE CORPORATION
Practice address
771 Airport Blvd
Ann Arbor, MI 48108
Phone
(734) 213-8011
Fax
(734) 213-8012
NPI assigned
May 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5301009841 MI Primary

Addresses

Primary practice location

771 Airport Blvd
Ann Arbor, MI 48108

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
2376829OtherNCPDP PROVIDER IDENTIFICATION NUMBER

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

NPI Registry JSON

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1497014757",
    "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": "771 AIRPORT BLVD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-213-8011",
            "fax_number": "734-213-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTCO WHOLESALE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-08",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "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": "MI",
            "license": "5301009841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2376829",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.