NPIMap

Organization Active NPI

Costco Wholesale Corporation

Doing business as Costco Pharmacy #1710

  • Specialty Pharmacy
  • Madison, WI
National Provider Identifier
1619735636
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
Legal business name
COSTCO WHOLESALE CORPORATION
Doing business as
Costco Pharmacy #1710
Practice address
310 Integrity Dr Ste 105
Madison, WI 53717-1416
Phone
(855) 213-0070
Fax
(855) 213-0125
NPI assigned
Mar 13, 2024
Last updated
Aug 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mail Order Pharmacy 3336M0002X NU
Specialty Pharmacy 3336S0011X NU Primary

Addresses

Primary practice location

310 Integrity Dr Ste 105
Madison, WI 53717-1416

Mailing address

PO Box 34300
Seattle, WA 98124-1300
Phone (425) 416-1294

Other names 1

  • Costco Pharmacy #1710 Doing business as

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

310 Integrity Dr
Ste 105
Madison, WI 53717
Phone (855) 213-0070

NPI Registry JSON

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1619735636",
    "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": "425-416-1294",
            "fax_number": "425-313-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 INTEGRITY DR STE 105",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171416",
            "telephone_number": "855-213-0070",
            "fax_number": "855-213-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTCO WHOLESALE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "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": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Costco Pharmacy #1710",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Costco Pharmacy #1710",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; 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.