COSTCO WHOLESALE CORPORATION (NPI# 1922399419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922399419 |
| Entity Type | Organization |
| Organization Name | COSTCO WHOLESALE CORPORATION |
| Other Organization Name | COSTCO PHARMACY # 1091 |
| Practice Address |
2680 Reynolds Ranch Pkwy Lodi CA 95240-6848 |
| Mailing Address |
Po Box 34300 Seattle WA 98124-1300 |
| Practice Telephone | 2093667301 |
| Practice Fax Number | 2093667302 |
| Mailing Telephone | 4253136670 |
| Mailing Fax Number | 4253136595 |
| Enumeration Date | 2011-05-02 |
| 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 |
50639 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 5640900 | 01 |
| Other Name | Type Code |
|---|---|
| COSTCO PHARMACY # 1091 | 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 |
2680 REYNOLDS RANCH PKWY |
| City | LODI |
| State | CA |
| Zip Code | 95240-6848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457686354 | Lue Yang | Pharmacist | 2680 Reynolds Ranch Pkwy, Lodi, CA 95240-6848 | 2009-10-09 |
| 1255960571 | Christina Ashley Gonzalez | Pharmacist | 2680 Reynolds Ranch Pkwy, Lodi, CA 95240-6848 | 2020-04-07 |
| 1396276705 | Yvonne Phan | Pharmacist | 2680 Reynolds Ranch Pkwy, Lodi, CA 95240-6848 | 2017-03-27 |
| 1407391394 | Eia Lee Song | Pharmacist | 2680 Reynolds Ranch Pkwy, Lodi, CA 95240-6848 | 2016-12-30 |
| 1689040909 | Nichole Cuenco Saqueton | Pharmacist | 2680 Reynolds Ranch Pkwy, Lodi, CA 95240-6848 | 2015-08-20 |
| 1710370820 | Costco Wholesale Corporation | Hearing Aid Equipment | 2680 Reynolds Ranch Pkwy, Lodi, CA 95240-6848 | 2015-03-13 |
| 1609266147 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 2680 Reynolds Ranch Pkwy, Lodi, CA 95240-6848 | 2015-02-04 |
| 1457797334 | Charles Michael Simpson | Pharmacist | 2680 Reynolds Ranch Pkwy, Lodi, CA 95240-6848 | 2013-05-17 |
| 1578830717 | Don H Shiromizu | Pharmacist | 2680 Reynolds Ranch Pkwy, Pharmacy, Lodi, CA 95240-6848 | 2011-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962034991 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 1139 E. Kettleman Lane, Suite 101, Lodi, CA 95240 | 2020-02-07 |
| 1548747082 | Gill and Patel Dental Corporation | Dentist | 2610 Reynolds Ranch Pkwy, Ste 100, Lodi, CA 95240 | 2018-07-27 |
| 1629511308 | Jose Daniel Garcia | Licensed Vocational Nurse | 12755 Ca-88, Lodi, CA 95240 | 2016-11-29 |
| 1104372754 | Jocelyn Janel Shilue | Specialist/Technologist | 705 Brandywine Drive, Lodi, CA 95240 | 2016-09-01 |
| 1750735965 | Natharchia R Peoples | Counselor | 9150 Ca-12, Lodi, CA 95240 | 2016-04-14 |
| 1891189403 | Valley Community Couseling Services | Case Management | 1300 W. Lodi Ste G-2, Stockton, CA 95240 | 2015-03-20 |
| 1114317195 | Carol Kooyman | Speech-Language Pathologist | 831 So. Lee Ave., Lodi, CA 95240 | 2015-01-29 |
| 1730514464 | Richard Barry Sirard | Pharmacist | 520 S Cherokee Lane, Lodi, CA 95240 | 2013-09-12 |
| 1740622570 | Joshlynn Uribe | Marriage & Family Therapist | 13520 E Live Oak Rd, Lodi, CA 95240 | 2013-07-22 |
| 1902172406 | Sital Singh | Internal Medicine | 999 S Fairmont Ave Ste 125, Lodi, CA 95240 | 2012-03-29 |
| Find all providers in zip 95240 | ||||
| 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 |
|---|---|---|---|---|
| 1689063331 | Fairmont Pharmacy | Pharmacy | 1121 W Vine St Ste 13, Suite 13, Lodi, CA 95240-5137 | 2015-01-20 |
| 1003000258 | Lodi Pharmacy Inc | Pharmacy | 929 S Cherokee Ln, Lodi, CA 95240-4304 | 2007-08-30 |
| 1871687343 | Spring Green Pharmacy | Pharmacy | 103 Lodi St, Lodi, WI 53555-1218 | 2006-10-02 |
| 1548363377 | Ohio Cvs Stores LLC | Pharmacy | 116 Ainsworth St, Lodi, OH 44254-1303 | 2006-09-07 |
| 1730299496 | Raleys | Pharmacy | 311 S Lower Sacramento Rd, Lodi, CA 95242-3322 | 2006-08-30 |
| 1487698825 | Longs Drug Stores California LLC | Pharmacy | 100 W Lodi Ave, Lodi, CA 95240-3517 | 2006-06-16 |
| 1376684233 | Rizzo's Pharmacy | Pharmacy | 122 S Main St, Lodi, NJ 07644-2204 | 2007-02-12 |
| 1295714400 | Save Mart Supermarkets | Pharmacy | 610 W Kettleman Ln, Lodi, CA 95240-6050 | 2006-01-16 |
| 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.