NPIMap

Organization Active NPI

Costco Wholesale Corporation

Doing business as Costco Pharmacy #621

  • Community/Retail Pharmacy
  • Fort Myers, FL
National Provider Identifier
1598133449
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
36031 Issued in SC
Legal business name
COSTCO WHOLESALE CORPORATION
Doing business as
Costco Pharmacy #621
Practice address
10088 Gulf Center Dr
Fort Myers, FL 33913-8961
Phone
(239) 433-7249
NPI assigned
Sep 9, 2015
Last updated
Sep 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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

Authorized official

Name
Mr. Dave Lovell, RPH
Title
Pharmacist-in-Charge
Phone
(239) 433-7249

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PS53638 FL
Community/Retail Pharmacy 3336C0003X 0202214057 VA
Community/Retail Pharmacy 3336C0003X 36031 SC Primary

Addresses

Primary practice location

10088 Gulf Center Dr
Fort Myers, FL 33913-8961

Mailing address

10088 Gulf Center Dr
Fort Myers, FL 33913-8961
Phone (239) 433-7249

Other identifiers 1

IdentifierTypeStateIssuer
699245OtherNABP

Other names 1

  • Costco Pharmacy #621 Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1103221Costco Pharmacy #62110088 Gulf Center Dr, Fort Myers, FL 33913Certificate of waiverAug 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Costco Wholesale Corpor1,511 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

Locations

10088 Gulf Center Dr
Fort Myers, FL 33913
Phone (239) 433-7249

NPI Registry JSON

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441756800000",
    "number": "1598133449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10088 GULF CENTER DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138961",
            "telephone_number": "239-433-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10088 GULF CENTER DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138961",
            "telephone_number": "239-433-7249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTCO WHOLESALE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-09",
        "last_updated": "2015-09-09",
        "status": "A",
        "authorized_official_last_name": "LOVELL",
        "authorized_official_first_name": "DAVE",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARGE",
        "authorized_official_telephone_number": "239-433-7249",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PS53638",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0202214057",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "36031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "699245",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Costco Pharmacy #621",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.