NPIMap

Organization Active NPI

Costco Wholesale Corporation

Doing business as Costco Pharmacy #1769

  • Community/Retail Pharmacy
  • Stone Mountain, GA
National Provider Identifier
1891623989
Registry record updated Jul 24, 2026
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 #1769
Practice address
1915 W Park Place Blvd
Stone Mountain, GA 30087
Phone
(678) 748-3920
Fax
(678) 310-1942
NPI assigned
May 11, 2026
Last updated
Jul 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Authorized official

Name
Richard Stephens, RPH
Title
SVP Pharmacy
Phone
(425) 313-8259

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

1915 W Park Place Blvd
Stone Mountain, GA 30087

Mailing address

PO Box 34300
Seattle, WA 98124-1300
Phone (425) 416-2660

Other names 1

  • Costco Pharmacy #1769 Doing business as

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1778457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784851200000",
    "number": "1891623989",
    "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": "1915 W PARK PLACE BLVD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "30087",
            "telephone_number": "678-748-3920",
            "fax_number": "678-310-1942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTCO WHOLESALE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-11",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "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",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Costco Pharmacy #1769",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.