NPIMap

Organization Active NPI

Costco Wholesale Corporation

Doing business as Costco Pharmacy # 322

  • Community/Retail Pharmacy
  • Bridgewater, NJ
National Provider Identifier
1700996329
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS0057660 Issued in NJ
Legal business name
COSTCO WHOLESALE CORPORATION
Doing business as
Costco Pharmacy # 322
Practice address
325 Promenade Blvd
Bridgewater, NJ 08807-3457
Phone
(732) 584-1002
Fax
(732) 584-1010
NPI assigned
Aug 30, 2006
Last updated
May 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 28RS0057660 NJ Primary

Addresses

Primary practice location

325 Promenade Blvd
Bridgewater, NJ 08807-3457

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
3141467OtherNCPDP PROVIDER IDENTIFICATION NUMBER
0018741MedicaidNJ

Other names 1

  • COSTCO PHARMACY # 322 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080820000449 TX Part B Supplier - Centralized Flu Biller 4082679451 This NPI is an additional NPI on the enrollment
O20100930039906 NJ DME Supplier - Pharmacy 4082679451 Practice locations: Bridgewater, NJ

National Provider Directory

National Provider Directory
Tax ID family
Costco Pharmacy 391,511 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

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748304000000",
    "number": "1700996329",
    "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": "325 PROMENADE BLVD",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088073457",
            "telephone_number": "732-584-1002",
            "fax_number": "732-584-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTCO WHOLESALE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "AVP PHARMACY",
        "authorized_official_telephone_number": "425-313-8259"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS0057660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3141467",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018741",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COSTCO PHARMACY # 322",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgewater, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.