COSTCO WHOLESALE CORPORATION (NPI# 1477944510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477944510 |
| Entity Type | Organization |
| Organization Name | COSTCO WHOLESALE CORPORATION |
| Other Organization Name | COSTCO OPTICAL #1161 |
| Practice Address |
5110 Value Dr Fort Wayne IN 46808-4048 |
| Mailing Address |
Po Box 35005 Seattle WA 98124-3405 |
| Practice Telephone | 2604811100 |
| Mailing Telephone | 4253138100 |
| Mailing Fax Number | 4253136922 |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2020-02-27 |
| Authorized Official Name | ART SALAS (AVP OPTICAL) |
| Authorized Official Telephone | 2604811113 |
| Is Organization Subpart | Y |
| Parent Organization Name | COSTCO WHOLESALE CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Other Name | Type Code |
|---|---|
| Costco Optical #1161 | 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 |
5110 VALUE DR |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46808-4048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770605073 | Danielle Faye Warren Teel | Optometrist | 5110 Value Dr, Fort Wayne, IN 46808-4048 | 2007-04-06 |
| 1245789825 | Josh Winebaugh | Pharmacist | 5110 Value Dr, Fort Wayne, IN 46808-4048 | 2016-09-23 |
| 1205202363 | Christopher L Vice | Pharmacist | 5110 Value Dr, Fort Wayne, IN 46808-4048 | 2015-08-12 |
| 1508251877 | Costco Wholesale Corporation | Hearing Aid Equipment | 5110 Value Dr, Fort Wayne, IN 46808-4048 | 2015-04-02 |
| 1740682152 | Travis Plumley | Pharmacist | 5110 Value Dr, Fort Wayne, IN 46808-4048 | 2014-09-17 |
| 1730504648 | Angela Fanning | Pharmacist | 5110 Value Dr, Fort Wayne, IN 46808-4048 | 2014-02-28 |
| 1982043691 | Teel Family Eye Care | Optometrist | 5110 Value Dr, Fort Wayne, IN 46808-4048 | 2013-06-17 |
| 1548608821 | Costco Wholesale Corporation | Pharmacy | 5110 Value Dr, Fort Wayne, IN 46808 | 2013-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347102 | Austin Hartzog | Pharmacist | 5110 Value Drive, Fort Wayne, IN 46808 | 2020-08-21 |
| 1407358377 | Bryan Black | Specialist/Technologist | 3946 Ice Way Fort Wayne, Fort Wayne, IN 46808 | 2018-03-06 |
| 1326557877 | Kimberly K Kolb | Occupational Therapy Assistant | 1431 Runnion Ave, Fort Wayne, IN 46808 | 2017-09-28 |
| 1396142063 | Christina Ryder | Specialist/Technologist | 3946 Iceway, Fort Wayne, IN 46808 | 2014-11-25 |
| 1912090440 | Neighborcare of Indiana, LLC | Pharmacy | 3402 Congressional Pkwy, Ft. Wayne, IN 46808 | 2006-10-02 |
| 1619945888 | Beth Ann Herrell | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2006-03-14 |
| 1568458990 | Carolyn Warner Greer | Obstetrics & Gynecology | 1415 Directors Row, Fort Wayne, IN 46808 | 2005-09-21 |
| 1750851168 | Tyler Cheney | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2018-11-28 |
| 1487123550 | Michaela Mcguire | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2018-11-19 |
| 1861961088 | Olivia Marquardt | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2018-11-16 |
| Find all providers in zip 46808 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760993810 | Longe Enterprises Corp | Eyewear Supplier (Equipment, not the service) | 5711 Ymca Park Dr East, Fort Wayne, IN 46835 | 2017-10-17 |
| 1881927317 | Longe Optical-north Inc | Eyewear Supplier (Equipment, not the service) | 4534 Maplecrest Rd, Fort Wayne, IN 46835-3970 | 2009-09-16 |
| 1700932415 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 333 East Coliseum Boulevard, Fort Wayne, IN 46805 | 2007-01-26 |
| 1770667917 | Longe Optical | Eyewear Supplier (Equipment, not the service) | 7625 Southtown Crossing, Fort Wayne, IN 46816-2506 | 2006-10-24 |
| 1649293903 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 4201 Coldwater Road, Fort Wayne, IN 46805 | 2006-07-26 |
| 1205822145 | Tri-state Optical, Inc. | Eyewear Supplier (Equipment, not the service) | 5233 Coldwater Rd, Fort Wayne, IN 46825-5538 | 2005-09-26 |
| 1013903962 | Tristate Optical, Inc. | Eyewear Supplier (Equipment, not the service) | 6424 W Jefferson Blvd, Fort Wayne, IN 46804-6204 | 2005-09-26 |
| 1528584562 | Eyecare Express | Eyewear Supplier (Equipment, not the service) | 700 E Coliseum Blvd, Fort Wayne, IN 46805-1220 | 2017-08-22 |
| 1194123026 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 515 E Coliseum Blvd, Fort Wayne, IN 46805-1215 | 2014-12-09 |
| 1013255884 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 6309 Lima Rd, Fort Wayne, IN 46818-1425 | 2013-01-29 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46808 |
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.