NPIMap

Organization Active NPI

Costco Wholesale Corporation

Doing business as Costco Pharmacy

  • Community/Retail Pharmacy
  • Las Vegas, NV
National Provider Identifier
1811007438
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
COSTCO WHOLESALE CORPORATION
Doing business as
Costco Pharmacy
Practice address
222 S Martin L King Blvd
Las Vegas, NV 89106-4305
Phone
(702) 384-5781
Fax
(702) 384-1137
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
Director Insurance Plans
Phone
(425) 313-8259

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PH00896 NV
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

222 S Martin L King Blvd
Las Vegas, NV 89106-4305

Mailing address

222 S Martin L King Blvd
Las Vegas, NV 89106-4305

Other identifiers 1

IdentifierTypeStateIssuer
2905000OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • COSTCO PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080820000449 TX Part B Supplier - Centralized Flu Biller 4082679451 This NPI is an additional NPI on the enrollment

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 13

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

View all 13

Locations

222 S Martin Luther King Blvd
Las Vegas, NV 89106
Phone (702) 450-3937

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": "1811007438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S MARTIN L KING BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S MARTIN L KING BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064305",
            "telephone_number": "702-384-5781",
            "fax_number": "702-384-1137"
        }
    ],
    "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": "DIRECTOR INSURANCE PLANS",
        "authorized_official_telephone_number": "425-313-8259"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NV",
            "license": "PH00896",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2905000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COSTCO PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

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.