NPIMap

Organization Active NPI

Costco Wholesale Corporation

  • Eyewear Supplier
  • Lodi, CA
National Provider Identifier
1609266147
Registry record updated Jun 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
D7583 Issued in CA
Legal business name
COSTCO WHOLESALE CORPORATION
Practice address
2680 Reynolds Ranch Pkwy
Lodi, CA 95240-6848
Phone
(209) 366-7300
Fax
(209) 366-7310
NPI assigned
Feb 4, 2015
Organization subpart
Yes
Parent organization
COSTCO WHOLESALE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2020

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

Authorized official

Name
Art Salas
Title
Avp Optical
Phone
(209) 366-7300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X D7583 CA Primary

Addresses

Primary practice location

2680 Reynolds Ranch Pkwy
Lodi, CA 95240-6848

Mailing address

PO Box 35005
Seattle, WA 98124-3405
Phone (425) 313-8100

Other names 1

  • Costco Optical #1091 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Costco Pharmacy 3021,506 organizations share this tax ID, including this one
Part of
Costco Pharmacy 302

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

2680 Reynolds Ranch Pkwy
Lodi, CA 95240
Phone (209) 366-7300

NPI Registry JSON

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591315200000",
    "number": "1609266147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35005",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981243405",
            "telephone_number": "425-313-8100",
            "fax_number": "425-313-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 REYNOLDS RANCH PKWY",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952406848",
            "telephone_number": "209-366-7300",
            "fax_number": "209-366-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTCO WHOLESALE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COSTCO WHOLESALE CORPORATION",
        "enumeration_date": "2015-02-04",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A",
        "authorized_official_last_name": "SALAS",
        "authorized_official_first_name": "ART",
        "authorized_official_title_or_position": "AVP OPTICAL",
        "authorized_official_telephone_number": "209-366-7300"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CA",
            "license": "D7583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Costco Optical #1091",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Costco Optical #1091",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2020; 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.