COSTCO WHOLESALE CORP (NPI# 1114130002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114130002 |
| Entity Type | Organization |
| Organization Name | COSTCO WHOLESALE CORP |
| Other Organization Name | COSTCO PHARMACY # 1001 |
| Practice Address |
2700 Park Ave Tustin CA 92782-2708 |
| Mailing Address |
Po Box 34300 Seattle WA 98124-1300 |
| Practice Telephone | 7143381942 |
| Practice Fax Number | 7143381936 |
| Mailing Telephone | 4253136670 |
| Mailing Fax Number | 4253136595 |
| Enumeration Date | 2007-05-07 |
| 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 |
48615 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 5626809 | 01 |
| Other Name | Type Code |
|---|---|
| COSTCO PHARMACY # 1001 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538352612 | Costco Wholesale Corp | Pharmacy | 6675 Marie Curie Dr, Elkridge, MD 21075 | 2007-08-22 |
| 1518167493 | Costco Wholesale Corp | Pharmacy | 1021 Woodruff Rd, Greenville, SC 29607 | 2007-07-19 |
| 1669593042 | Costco Wholesale Corp | Pharmacy | 11001 Southern Blvd, Royal Palm Beach, FL 33411 | 2007-04-03 |
| 1124149604 | Costco Wholesale Corp | Pharmacy | 10088 Gulf Center Dr, Fort Myers, FL 33913 | 2007-04-03 |
| 1326179250 | Costco Wholesale Corp | Pharmacy | 501 Waterfront Dr W, West Homestead, PA 15120 | 2007-03-09 |
| 1942343421 | Costco Wholesale Corp | Pharmacy | 16375 Washington St, Thornton, CO 80023 | 2007-02-15 |
| 1245399617 | Costco Wholesale Corp | Pharmacy | 4300 Nuhou St, Lihue, HI 96766 | 2006-12-08 |
| 1679667927 | Costco Wholesale Corp | Pharmacy | 11330 Fountains Dr, Maple Grove, MN 55369 | 2006-10-03 |
| 1942394291 | Costco Wholesale Corp | Pharmacy | 170 Cooley Mesa Rd, Gypsum, CO 81637 | 2006-10-03 |
| 1366536765 | Costco Wholesale Corp | Pharmacy | 2838 Wake Forest Rd, Raleigh, NC 27609 | 2006-10-03 |
| 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 |
2700 PARK AVE |
| City | TUSTIN |
| State | CA |
| Zip Code | 92782-2708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972112167 | Paula Le | Pharmacy | 2700 Park Ave, Tustin, CA 92782-2708 | 2020-07-23 |
| 1972137057 | Kristy K L Hsu | Pharmacist | 2700 Park Ave, Tustin, CA 92782-2708 | 2020-02-27 |
| 1184017253 | Costco Wholesale Corporation | Hearing Aid Equipment | 2700 Park Ave, Tustin, CA 92782-2708 | 2015-03-12 |
| 1952790420 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 2700 Park Ave, Tustin, CA 92782-2708 | 2015-01-21 |
| 1639480288 | Jenny Co | Pharmacist | 2700 Park Ave, Tustin, CA 92782-2708 | 2010-06-29 |
| 1295929370 | Jenee Suzanne Lee | Optometrist | 2700 Park Ave, Tustin, CA 92782-2708 | 2007-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548890528 | Christina Maria Clayton | Registered Nurse | 3100 Park Ave Apt 7-201, Tustin, CA 92782 | 2020-01-18 |
| 1447769963 | National Vision, Inc. | Technician/Technologist | 15020 Kensington Park Drive, J300, Tustin, CA 92782 | 2017-09-27 |
| 1487175410 | Vanson Dental Corporation | Dentist | 15160 Kensington Park Drive, Ste 610, Tustin, CA 92782 | 2017-06-29 |
| 1982133526 | Hee Eun Lee | Occupational Therapist | 2741 Dunstan Drive, Tustin, CA 92782 | 2017-06-07 |
| 1881129229 | Lydia Anna Bray | Pharmacist | 2102 Seminole, Tustin, CA 92782 | 2017-04-24 |
| 1427591577 | Charlie Huang | Internal Medicine | 15000 Kensington Park Dr Ste 250, Tustin, CA 92782 | 2016-11-21 |
| 1144672270 | Leiza Yamila Walia | Dentist | 15160 Kensington Park Dr Ste 610, Tustin, CA 92782 | 2016-07-13 |
| 1467831131 | Steven Yi Sun | Pediatrics | 15000 Kensington Park Dr, Tustin, CA 92782 | 2015-05-27 |
| 1639506405 | Medivan | Non-emergency Medical Transport (VAN) | 13800 Parkcenter Lane, Tustin, CA 92782 | 2013-10-10 |
| 1124266085 | Stacie Lynn Aragon | Counselor | 1 Hope Dr., Tustin, CA 92782 | 2009-01-30 |
| Find all providers in zip 92782 | ||||
| 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 |
|---|---|---|---|---|
| 1912529645 | Gencare Pharmacy Inc | Pharmacy | 15761 Tustin Village Way Ste 108, Tustin, CA 92780-8328 | 2020-05-15 |
| 1376822015 | Huong Luu Pharmd Inc | Pharmacy | 17400 Irvine Blvd Ste P, Tustin, CA 92780-3030 | 2011-08-12 |
| 1730222670 | Tustin Community Pharmacy Inc | Pharmacy | 13400 Newport Ave, Tustin, CA 92780-3753 | 2007-02-14 |
| 1588774186 | Costco Wholesale Corporation | Pharmacy | 2655 El Camino Real, Tustin, CA 92782 | 2006-08-30 |
| 1639114531 | Garfield Beach Cvs LLC | Pharmacy | 671 E 1st St, Tustin, CA 92780-3417 | 2006-06-17 |
| 1295281285 | Tustin Newport Pharmacy Inc | Pharmacy | 13400 Newport Ave, Tustin, CA 92780-3753 | 2016-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689987 | Capsule San Diego LLC | Pharmacy | 1450 Columbia St Ste B, San Diego, CA 92101-3487 | 2020-11-04 |
| 1023618824 | Ingram's Pharmacy, LLC | Pharmacy | 1115 Union Ave Unit 147-1c, Bakersfield, CA 93307-1050 | 2020-10-29 |
| 1750981874 | Capsule San Francisco LLC | Pharmacy | 475 University Ave, Palo Alto, CA 94301-1814 | 2020-10-28 |
| 1447850623 | Sterling Hatteras LLC | Pharmacy | 916 E Cypress Ave Ste 300, Redding, CA 96002-1038 | 2020-10-28 |
| 1922608454 | Vanessa Ann Marie Rita Pitts | Pharmacy | 26365 Buccaneer Ln, Helendale, CA 92342-7739 | 2020-10-26 |
| 1205435971 | Rinaldi Pharmacy, Inc. | Pharmacy | 11237 Tampa Ave, Porter Ranch, CA 91326-1610 | 2020-10-22 |
| 1467051300 | San Dimas Wellness Pharmacy | Pharmacy | 830 W Arrow Hwy Ste 830b, San Dimas, CA 91773-2498 | 2020-10-21 |
| 1225636889 | Med-plus Pharmacy Inc | Pharmacy | 335 Lindbergh Ave, Livermore, CA 94551-9291 | 2020-10-15 |
| 1689271066 | Innova Pharmacy Iv | Pharmacy | 4815 Watt Ave Ste B101, North Highlands, CA 95660-5108 | 2020-10-08 |
| 1114524683 | Bear Valley Pharmacy | Pharmacy | 17003 Bear Valley Rd Ste B, Hesperia, CA 92345-1420 | 2020-10-07 |
| Find all providers with the same taxonomy | ||||
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| 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.