NPIMap

Organization Active NPI

Costco Wholesale Corporation

Doing business as Costco Optical #1628

  • Eyewear Supplier
  • Longmont, CO
National Provider Identifier
1962106963
Registry record updated Mar 27, 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 #1628
Practice address
205 E Ken Pratt Blvd
Longmont, CO 80501-8500
Phone
(303) 827-2534
NPI assigned
Mar 27, 2023
Last updated
Mar 27, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
COSTCO WHOLESALE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Authorized official

Name
Art Salas
Title
VP Optical
Phone
(425) 416-5360

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

205 E Ken Pratt Blvd
Longmont, CO 80501-8500

Mailing address

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

Other names 1

  • Costco Optical #1628 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Costco Pharmacy 1391,511 organizations share this tax ID, including this one
Part of
Costco Pharmacy 139

Organizations with this tax ID in the same state 12

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

Locations

205 E Ken Pratt Blvd
Longmont, CO 80501
Phone (303) 827-2534

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1962106963",
    "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": "205 E KEN PRATT BLVD",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805018500",
            "telephone_number": "303-827-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTCO WHOLESALE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COSTCO WHOLESALE CORPORATION",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A",
        "authorized_official_last_name": "SALAS",
        "authorized_official_first_name": "ART",
        "authorized_official_title_or_position": "VP OPTICAL",
        "authorized_official_telephone_number": "425-416-5360"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Costco Optical #1628",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.