Organization Active NPI

Costco Wholesale Corporation

  • Eyewear Supplier
  • McDonough, GA
National Provider Identifier
1912787656
Registry record updated Oct 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
COSTCO WHOLESALE CORPORATION
Doing business as
Costco Optical #1675
Practice address
2245 Jodeco Rd
McDonough, GA 30253-5210
Phone
(678) 272-3288
NPI assigned
Oct 2, 2023
Organization subpart
Yes
Parent organization
COSTCO WHOLESALE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 28, 2023

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

Authorized official

Name
Erin Sieglock
Title
Avp-Optical
Phone
(425) 313-8087

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

2245 Jodeco Rd
McDonough, GA 30253-5210

Mailing address

PO Box 35005
Seattle, WA 98124-3405
Phone (425) 313-8100

Other names 1

  • Costco Optical #1675 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Costco Pharmacy 3021,506 organizations share this tax ID, including this one
Part of
Costco Pharmacy 302

Organizations with this tax ID in the same state 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698451200000",
    "number": "1912787656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35005",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981243405",
            "telephone_number": "425-313-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 JODECO RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302535210",
            "telephone_number": "678-272-3288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTCO WHOLESALE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COSTCO WHOLESALE CORPORATION",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-28",
        "certification_date": "2023-10-28",
        "status": "A",
        "authorized_official_last_name": "SIEGLOCK",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "AVP-OPTICAL",
        "authorized_official_telephone_number": "425-313-8087"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Costco Optical #1675",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Costco Optical #1675",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2023; 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.