Costco Wholesale Corporation

Organization Active NPI Community/Retail Pharmacy · Selma, TX

NPI 1992998702 · NPPES record last updated May 14, 2024

Key facts

NPI
1992998702
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
25721 (TX)
Legal business name
COSTCO WHOLESALE CORPORATION
Practice address
15330 Ih 35 N
Selma, TX 78154
Phone
(210) 332-1081
Fax
(210) 332-1078
NPI assigned
Aug 24, 2007
Organization subpart
No

Authorized official

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 25721 TX Yes

Addresses

Primary practice location

15330 Ih 35 N
Selma, TX 78154

Mailing address

PO Box 34300
Seattle, WA 98124-1300
Phone (425) 313-6670

Other identifiers

IdentifierTypeStateIssuer
4545731OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names

  • Costco Pharmacy #1006 Doing business as

Other providers in Selma, TX

All providers in Selma, TX · Community/Retail Pharmacy in Texas

Sources for this page

Verify at the official NPI Registry.