COSTCO WHOLESALE CORPORATION (NPI# 1164532776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164532776 |
| Entity Type | Organization |
| Organization Name | COSTCO WHOLESALE CORPORATION |
| Other Organization Name | COSTCO PHARMACY # 187 |
| Practice Address |
3980 Venture Dr Duluth GA 30096-5077 |
| Mailing Address |
Po Box 34300 Seattle WA 98124-1300 |
| Practice Telephone | 7706221330 |
| Practice Fax Number | 7706221320 |
| 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 |
8041 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 1143180 | 01 |
| Other Name | Type Code |
|---|---|
| COSTCO PHARMACY # 187 | 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 |
3980 VENTURE DR |
| City | DULUTH |
| State | GA |
| Zip Code | 30096-5077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124526645 | Binh Duong | Pharmacist | 3980 Venture Dr, Duluth, GA 30096-5077 | 2018-01-30 |
| 1568913770 | Melanie Quynh-tien Nguyen | Pharmacy | 3980 Venture Dr, Duluth, GA 30096-5077 | 2016-10-24 |
| 1124413067 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 3980 Venture Dr, Duluth, GA 30096-5077 | 2015-03-30 |
| 1144612953 | Costco Wholesale Corporation | Hearing Aid Equipment | 3980 Venture Dr, Duluth, GA 30096-5077 | 2015-03-03 |
| 1154607786 | Floyd A Rivera | Pharmacist | 3980 Venture Dr, Suite W100, Duluth, GA 30096-5077 | 2011-10-27 |
| 1609151240 | Timothy James Blanck | Pharmacist | 3980 Venture Dr, Duluth, GA 30096-5077 | 2011-10-14 |
| 1598048746 | Terry S White | Pharmacist | 3980 Venture Dr, Duluth, GA 30096-5077 | 2011-09-23 |
| 1124194949 | Patrick L Flores | Optometrist | 3980 Venture Dr, Duluth, GA 30096-5077 | 2006-11-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1568090868 | Positive Behavior Services, Inc | Behavior Technician | 3765 Crestwood Pkwy Nw, Duluth, GA 30096 | 2020-03-31 |
| 1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
| 1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
| 1083184626 | Aica Orthopedics, P.C. | Orthopaedic Surgery | 3775 Venture Drive Bldg F, Duluth, GA 30096 | 2018-11-27 |
| 1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
| 1235611724 | Katherine Winstead Knott | Counselor | 3460 Summit Ridge Parkway, Suite 503, Duluth, GA 30096 | 2018-08-31 |
| 1710467857 | Envision Optics LLC | Optometrist | 1943 Pleasant Hill Rd, Duluth, GA 30096 | 2018-08-17 |
| 1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
| 1053839456 | Rogers Bridge Pediatric Therapy, LLC | Clinic/Center | 2845 Summercrest Ln, Duluth, GA 30096 | 2017-09-06 |
| Find all providers in zip 30096 | ||||
| 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 |
|---|---|---|---|---|
| 1043782998 | Anchor Plus Rx, LLC | Pharmacy | 3800 Pleasant Hill Rd Ste 2, Duluth, GA 30096-1428 | 2018-12-17 |
| 1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
| 1073917449 | Suju Enterprise Inc | Pharmacy | 4195 Pleasant Hill Rd.suite D, Duluth, GA 30096 | 2014-10-14 |
| 1285050823 | Duluth Pharmacy LLC | Pharmacy | 3890 Pleasant Hill Rd Ste 103, Duluth, GA 30096-4807 | 2014-03-06 |
| 1326383498 | Corner Pharmacy Inc | Pharmacy | 2550 Pleasant Hill Rd Ste 120, Duluth, GA 30096-9278 | 2012-11-30 |
| 1265627681 | Falks Woodland Pharmacy Inc | Pharmacy | 1600 Woodland Ave, Duluth, MN 55803-2628 | 2007-09-10 |
| 1063627271 | Prescription Specialties | Pharmacy | 1601 London Rd, Duluth, MN 55812-1620 | 2007-05-11 |
| 1205978996 | Bingamite | Pharmacy | 113 N 2nd Ave W, Duluth, MN 55802-1911 | 2007-02-12 |
| 1215019005 | Duluth Rexall Pharmacy Inc | Pharmacy | 3165 Buford Hwy, Duluth, GA 30096-3351 | 2006-10-20 |
| 1982707733 | Georgia Cvs Pharmacy LLC | Pharmacy | 4110 Pleasant Hill Rd, Duluth, GA 30096-4853 | 2006-09-07 |
| Find all providers in DULUTH | ||||
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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.