Costco Wholesale Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

100-1989 Issued in SD

Legal business name

COSTCO WHOLESALE CORPORATION

Doing business as

Costco Pharmacy #1159

Practice address

3700 S Grange Ave
Sioux Falls, SD 57105

Phone

(605) 988-9150

Fax

(605) 988-9141

NPI assigned

Aug 2, 2013

Last updated

Mar 19, 2024By the provider in NPPES

Organization subpart

No

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 1

Addresses

Other identifiers 1

Other names 1

• Costco Pharmacy #1159 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Tax ID family

Costco Pharmacy 391,511 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 2

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Costco Wholesale Corporation

  dba Costco Hearing Aid #1159

  • Hearing Aid Equipment
  • Sioux Falls, SD
  • NPI 1558755801
  NPD tax ID
• Costco Wholesale Corporation

  dba Costco Optical #1159

  • Eyewear Supplier
  • Sioux Falls, SD
  • NPI 1902297658
  NPD tax ID

Locations

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Costco Wholesale Corporation

  dba Costco Hearing Aid #1159

  • Hearing Aid Equipment
  • Sioux Falls, SD
  • NPI 1558755801
  NPPES parent name
• Costco Wholesale Corporation

  dba Costco Optical #1159

  • Eyewear Supplier
  • Sioux Falls, SD
  • NPI 1902297658
  NPPES parent name

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

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1750713574",
    "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": "425-416-2660",
            "fax_number": "425-313-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 S GRANGE AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "57105",
            "telephone_number": "605-988-9150",
            "fax_number": "605-988-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTCO WHOLESALE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-02",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SD",
            "license": "100-1989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2141574",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Costco Pharmacy #1159",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Meghan Grace Corr, RN, CNP
• Dawn Theresa Corriere, CNM
• Paul David Cortez, D.D.S.
• Valerie Marie Costa, RRT
• Costco Wholesale Corporation (Costco Hearing Aid #1159)
• Costco Wholesale Corporation (Costco Optical #1159)
• Peter Robert Cote, LPN
• John Michael Cotton
• Joseph Donald Cotton, DC
• Megan Cotton

• Community/Retail Pharmacy in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Community/Retail Pharmacy in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.