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Contact Information

COSTCO WHOLESALE CORPORATION
9404 CENTRAL AVE
MONTCLAIR, CA91763
 Phone: 909-575-5003
 Fax: 909-575-5025
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for COSTCO WHOLESALE CORPORATION

NPI Number 1134239734
LBN Legal business name COSTCO WHOLESALE CORPORATION
Authorized official RICHARD STEPHENS - (SVP PHARMACY)
Entity Organization
Organization subpart 1 No
Enumeration date 08/30/2006
Last updated 05/21/2025 - More than a year ago
Identifiers
CA License # PHY45636
Other 1998640 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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