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Costco Wholesale Corporation

Organization Active NPI Eyewear Supplier · Grand Chute, WI

NPI 1699159798 · NPPES record last updated Feb 27, 2020

Key facts

NPI
1699159798
Entity type
Organization (NPI type 2)
Primary specialty
Eyewear Supplier 332H00000X
Legal business name
COSTCO WHOLESALE CORPORATION
Practice address
5401 W. Integrity Way
Grand Chute, WI 54913
Phone
(425) 313-8100
NPI assigned
Jul 17, 2015
Organization subpart
Yes
Parent organization (as reported)
COSTCO WHOLESALE CORPORATION

Authorized official

Name
Art Salas
Title
Avp Optical
Phone
(920) 815-4513

Corporate family (same tax ID) 23

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Costco Pharmacy 302 (1,506 organizations share this tax ID)
Part of
Costco Pharmacy 302

Locations

5401 W Integrity Way
Grand Chute, WI 54913
Phone (920) 363-7010

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Yes

Addresses

Primary practice location

5401 W. Integrity Way
Grand Chute, WI 54913

Mailing address

PO Box 35005
Seattle, WA 98124-3405

Other names

  • Costco Optical #1222 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 27, 2020.

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582761600000",
    "number": "1699159798",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 W. INTEGRITY WAY",
            "city": "GRAND CHUTE",
            "state": "WI",
            "postal_code": "54913",
            "telephone_number": "425-313-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTCO WHOLESALE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COSTCO WHOLESALE CORPORATION",
        "enumeration_date": "2015-07-17",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A",
        "authorized_official_last_name": "SALAS",
        "authorized_official_first_name": "ART",
        "authorized_official_title_or_position": "AVP OPTICAL",
        "authorized_official_telephone_number": "920-815-4513"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Costco Optical #1222",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Costco Optical #1222",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Chute, WI

All providers in Grand Chute, WI · Eyewear Supplier in Wisconsin

Sources for this page

Verify at the official NPI Registry.