COSTCO WHOLESALE CORPORATION (NPI# 1114037728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114037728 |
| Entity Type | Organization |
| Organization Name | COSTCO WHOLESALE CORPORATION |
| Other Organization Name | COSTCO PHARMACY # 41 |
| Practice Address |
1900 Santa Rosa Ave Santa Rosa CA 95407-7621 |
| Mailing Address |
Po Box 34300 Seattle WA 98124-1300 |
| Practice Telephone | 7075781711 |
| Practice Fax Number | 7075786287 |
| Mailing Telephone | 4253136670 |
| Mailing Fax Number | 4253136595 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2014-08-18 |
| Authorized Official Name | MICHAEL MASTROMONICA (AVP PHARMACY) |
| 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 |
PHY41310 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 0591633 | 01 |
| Other Name | Type Code |
|---|---|
| COSTCO PHARMACY # 41 | 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 |
1900 SANTA ROSA AVE |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95407-7621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407249030 | Costco Wholesale Corporation | Hearing Aid Equipment | 1900 Santa Rosa Ave, Santa Rosa, CA 95407-7621 | 2015-03-06 |
| 1619367307 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 1900 Santa Rosa Ave, Santa Rosa, CA 95407-7621 | 2015-02-02 |
| 1326304247 | Bradley Ingalls Hall | Optometrist | 1900 Santa Rosa Ave, Santa Rosa, CA 95407-7621 | 2012-04-04 |
| 1063791671 | Tramy Uyesugi | Pharmacist | 1900 Santa Rosa Ave, Santa Rosa, CA 95407-7621 | 2011-08-12 |
| 1891073490 | Clyde M Mcalpin | Pharmacist | 1900 Santa Rosa Ave, Santa Rosa, CA 95407-7621 | 2011-07-30 |
| 1134407729 | Michael G Missakian | Pharmacist | 1900 Santa Rosa Ave, Santa Rosa, CA 95407-7621 | 2011-07-29 |
| 1356648265 | Juliann Trout | Pharmacist | 1900 Santa Rosa Ave, Santa Rosa, CA 95407-7621 | 2011-02-12 |
| 1750445318 | Bradley I. Hall, O.d., P.C. | Optometrist | 1900 Santa Rosa Ave, Santa Rosa, CA 95407-7621 | 2006-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100477 | Charrise Reece | Case Management | 935 S Davis, Santa Rosa, CA 95407 | 2020-10-07 |
| 1629687256 | Suzel Anne-marie Deer | Registered Nurse | 1017 Stony Point Rd, Santa Rosa, CA 95407 | 2020-07-29 |
| 1285152884 | Mercedes Zipperle | Specialist/Technologist | 638 Athena Pl, Santa Rosa, CA 95407 | 2017-09-03 |
| 1235664988 | Priceless Transport Care LLC | Non-emergency Medical Transport (VAN) | 661 Powderhorn Ave, Santa Rosa, CA 95407 | 2017-05-01 |
| 1780139634 | Robin Shank Sanderson | Nurse Practitioner | 751 Lombardi, Santa Rosa, CA 95407 | 2016-08-22 |
| 1205207321 | Flaman Craig Mccloud Jr. | Counselor | 440 Arrowood Dr., Santa Rosa, CA 95407 | 2015-10-15 |
| 1548679400 | Jill Bauer | Dental Hygienist | 2740 Ironstone Circle, Santa Rosa, CA 95407 | 2014-08-05 |
| 1922413673 | Aurora Alejandra Gomez Selpides | Family Medicine | 2240 Mercury Way, Santa Rosa, CA 95407 | 2014-06-20 |
| 1508159955 | Luis Angel Gonzalez | Counselor | 1202 Apollo Way, Santa Rosa, CA 95407 | 2011-05-18 |
| 1326286295 | Kelly Alexis Rathmann | Social Worker | 3650 Standish Avenue, Santa Rosa, CA 95407 | 2009-01-29 |
| Find all providers in zip 95407 | ||||
| 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 |
|---|---|---|---|---|
| 1245873124 | Marin Apothecaries Inc | Pharmacy | 3569a Round Barn Cir, Santa Rosa, CA 95403-1757 | 2019-10-23 |
| 1770999708 | Marin Apothecaries Inc | Pharmacy | 1300 N Dutton Ave Ste 100, Santa Rosa, CA 95401-7112 | 2014-07-10 |
| 1871638767 | Save Mart Supermarkets | Pharmacy | 915 Montgomery Village Ct, Santa Rosa, CA 95405 | 2007-02-20 |
| 1619911062 | Longs Drug Stores California LLC | Pharmacy | 2771 4th St, Santa Rosa, CA 95405-4726 | 2006-06-16 |
| 1649212457 | Longs Drug Stores California LLC | Pharmacy | 2700 Yulupa Ave, Santa Rosa, CA 95405-8577 | 2006-06-13 |
| 1659313468 | Longs Drug Stores California LLC | Pharmacy | 463 Stony Point Rd, Santa Rosa, CA 95401-5900 | 2006-06-13 |
| 1093153850 | Guadalupe County | Pharmacy | 117 Camino De Vida, 200, Santa Rosa, NM 88435-2267 | 2013-06-13 |
| 1285782011 | Kaiser Foundation Health Plan Inc | Pharmacy | 401 Bicentennial Way, Santa Rosa, CA 95403-2149 | 2007-01-08 |
| 1497814594 | Jafa Pharmaceuticals, Inc. | Pharmacy | 95 Montgomery Dr, Santa Rosa, CA 95404 | 2006-12-06 |
| 1568572220 | Raleys | Pharmacy | 1407 Fulton Rd, Santa Rosa, CA 95403-1809 | 2006-08-30 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95407 |
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.