Costco Wholesale Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

7833 Issued in NC

Legal business name

COSTCO WHOLESALE CORPORATION

Doing business as

Costco Pharmacy

Practice address

1085 Hanes Mall Blvd
Winston Salem, NC 27103-1310

Phone

(336) 970-2302

Fax

(336) 970-2321

NPI assigned

Aug 30, 2006

Last updated

May 27, 2025By 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

Avp Pharmacy

Phone

(425) 313-8259

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• COSTCO PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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": "1871603407",
    "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": "1085 HANES MALL BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031310",
            "telephone_number": "336-970-2302",
            "fax_number": "336-970-2321"
        }
    ],
    "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": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "7833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2068902",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COSTCO PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anna Ayers Costa, LCMHC-A
• Nicholas Joseph Costa II, MD
• Peter Anthony Costa, MD
• Costco Wholesale Corporation (Costco Hearing Aid #361)
• Costco Wholesale Corporation (Costco Optical #361)
• Karen Hoke Coston
• Kristie Cothren, MA, CCC-SLP
• Deanna Marie Cotsalas, M.D., M.H.S.
• Amy Jo Couch, PMHNP
• Catherine Terese Coughlin, PA-C

• Community/Retail Pharmacy in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Community/Retail Pharmacy in North Carolina

• 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.