COSTCO WHOLESALE CORPORATION (NPI# 1013322296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013322296 |
| Entity Type | Organization |
| Organization Name | COSTCO WHOLESALE CORPORATION |
| Other Organization Name | COSTCO PHARMACY #1019 |
| Practice Address |
3571 W 10400 South South Jordan UT 84095 |
| Mailing Address |
Po Box 34300 Seattle WA 98124-1300 |
| Practice Telephone | 8015235297 |
| Practice Fax Number | 8015235288 |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2014-08-19 |
| Authorized Official Name | MICHAEL MASTROMONICA (AVP - PHARMACY SERVICES) |
| Authorized Official Telephone | 4253132892 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
9112581-1703 | UT | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2146661 | 01 |
| Other Name | Type Code |
|---|---|
| Costco Pharmacy #1019 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
| 1356954713 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 650 Garden Park Blvd, Cherry Hill, NJ 08002 | 2020-08-26 |
| 1609488378 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 4816 Bay City Rd, Midland, MI 48642 | 2020-08-23 |
| 1710599485 | Costco Wholesale Corporation | Pharmacy | 16261 S Boulevard Pl, Plainfield, IL 60586-4400 | 2020-08-23 |
| 1043838584 | Costco Wholesale Corporation | Pharmacy | 3403 W Chinden Blvd, Meridian, ID 83646-7151 | 2020-07-10 |
| 1316564628 | Costco Wholesale Corporation | Pharmacy | 16385 W Waddell Rd, Surprise, AZ 85388-9623 | 2020-07-02 |
| 1265054324 | Costco Wholesale Corporation | Pharmacy | 2495 E Lincoln Rd, Idaho Falls, ID 83401-2203 | 2020-05-12 |
| 1265072292 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 700 Highland Colony Pkwy, Ridgeland, MS 39157-8701 | 2020-01-07 |
| 1275183568 | Costco Wholesale Corporation | Hearing Aid Equipment | 995 Blue Gentian Rd, Eagan, MN 55121-1542 | 2019-09-18 |
| 1124675228 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 284 Flanders Rd, East Lyme, CT 06333-1710 | 2019-08-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | COSTCO WHOLESALE CORPORATION | 999 Lake Dr, Issaquah, WA 98027 |
| Washington State Corporations | COSTCO WHOLESALE CORPORATION | 999 Lake Dr, Issaquah, WA 98027-8990 |
| Colorado Business Entities | COSTCO WHOLESALE CORPORATION | 999 Lake Dr, Issaquah, WA 98027 |
| Iowa Business Entities | COSTCO WHOLESALE CORPORATION | 999 Lake Dr, Issaquah, WA 98027 |
| Vermont Business Registrations | COSTCO WHOLESALE CORPORATION | 999 Lake Drive, Issaquah, WA 98027 |
| New York State Corporations | COSTCO WHOLESALE CORPORATION | 28 Liberty St., New York, New York 10005 |
| Massachusetts Corporations | COSTCO WHOLESALE CORPORATION | 999 Lake Drive, Issaquah, WA 98027 |
| Connecticut Business Registrations | COSTCO WHOLESALE CORPORATION | 999 Lake Drive, Issaquah, WA 98027 |
| Virginia Business Entities | COSTCO WHOLESALE CORPORATION | 999 Lake Drive, Issaquah, Washington 98027 |
| Street Address |
3571 W 10400 SOUTH |
| City | SOUTH JORDAN |
| State | UT |
| Zip Code | 84095 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033745393 | Beverly Laraine Williams | Social Worker | 11260 S River Heights Drive, South Jordan, UT 84095 | 2020-03-19 |
| 1265902902 | Sarah Richele Kelley | Specialist/Technologist | 10236 Alder Grovey Way, South Jordan, UT 84095 | 2018-11-26 |
| 1326528837 | Kristi Couse | Massage Therapist | 10679 S 2200 W Apt 2, South Jordan, UT 84095 | 2018-08-15 |
| 1821516063 | River Crossing Dental Professional Corporation | Clinic/Center | 12427 South 4000 West, Suite #200, Riverton, UT 84095 | 2017-09-08 |
| 1245755719 | Staci Stout | Dental Hygienist | 3113 W Swiss Pass Cir, South Jordan, UT 84095 | 2017-08-07 |
| 1437698750 | Ryan Sears | Dentist | 10894 So. River Front Parkway, South Jordan, UT 84095 | 2017-02-20 |
| 1366989931 | Ultimate Sports Regenerative Medicine | Chiropractor | 1098 W. South Jordan Pkwy, Suite 101, South Jordan, UT 84095 | 2017-01-20 |
| 1306393889 | Tal Quirl | Optometrist | 3571 W. 10400 S., South Jordan, UT 84095 | 2016-09-01 |
| 1023562667 | Sevon Taroian | Social Worker | 11260 River Heights Drive, South Jordan, UT 84095 | 2016-08-11 |
| 1952762932 | Megan Buckley | Developmental Therapist | 881 Baxter Drive, Ste 100, South Jordan, UT 84095 | 2016-03-17 |
| Find all providers in zip 84095 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275838575 | University of Utah | Pharmacy | 4696 Daybreak Rim Way, South Jordan, UT 84095-5129 | 2011-01-18 |
| 1538645247 | Sojo Family Pharmacy Inc. | Pharmacy | 3583 W. 9800 S., South Jordan, UT 84095-8409 | 2018-07-16 |
| 1578652160 | University of Utah | Pharmacy | 5126 W Daybreak Pkwy, Room 101, South Jordan, UT 84009-5994 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881292167 | 3bc Incorporated | Pharmacy | 435 North Gateway Drive #802, Providence, UT 84332 | 2020-10-09 |
| 1598371973 | Mountain West Medicine Inc. | Pharmacy | 1551 Renaissance Towne Dr Ste 104, Bountiful, UT 84010-7682 | 2020-09-21 |
| 1518577741 | Black Panda LLC | Pharmacy | 2507 S State St, Salt Lake City, UT 84115-3109 | 2020-08-03 |
| 1235751900 | Roe Rx Inc | Pharmacy | 145 S 3000 W, West Point, UT 84015 | 2020-05-15 |
| 1023637675 | Santaquin Market, Inc. | Pharmacy | 110 N. 400 E., Santaquin, UT 84655 | 2020-04-14 |
| 1891345237 | Strive Pharmacy Utah 1 LLC | Pharmacy | 8928 S State St, Sandy, UT 84070-2246 | 2019-09-17 |
| 1336705755 | Bear Lake Community Health Center | Pharmacy | 517 W 100 N Ste 210, Providence, UT 84332-9826 | 2019-05-10 |
| 1912470246 | Ridley's Family Markets Inc | Pharmacy | 74 S 100 E, Tremonton, UT 84337-1606 | 2019-01-09 |
| 1437620762 | Pthl LLC | Pharmacy | 1890 Bonanza Dr Ste 107, Park City, UT 84060-7217 | 2018-12-16 |
| 1093285785 | Richfield Community Pharmacy LLC | Pharmacy | 440 S Main St Ste B, Richfield, UT 84701-2855 | 2018-11-26 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH JORDAN |
| Zip Code | 84095 |
Please comment or provide details below to improve the information on COSTCO WHOLESALE CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.