COSTCO WHOLESALE CORPORATION (NPI# 1982094025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982094025 |
| Entity Type | Organization |
| Organization Name | COSTCO WHOLESALE CORPORATION |
| Other Organization Name | COSTCO OPTICAL #488 |
| Practice Address |
2345 Fenton Pkwy San Diego CA 92108-4743 |
| Mailing Address |
Po Box 35005 Seattle WA 98124-3405 |
| Practice Telephone | 6193584000 |
| Practice Fax Number | 6193584005 |
| Mailing Telephone | 4253138100 |
| Mailing Fax Number | 4253136922 |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2020-06-11 |
| Authorized Official Name | ART SALAS (AVP OPTICAL) |
| Authorized Official Telephone | 6193584000 |
| 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) | D3839 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| Costco Optical #488 | 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 |
| Street Address |
2345 FENTON PKWY |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92108-4743 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225148828 | Costco Wholesale Corporation | Pharmacy | 2345 Fenton Pkwy, San Diego, CA 92108-4743 | 2006-08-30 |
| 1508314535 | Khoa Nguyen | Pharmacist | 2345 Fenton Pkwy, San Diego, CA 92108-4743 | 2016-09-19 |
| 1346633575 | Costco Wholesale Corporation | Hearing Aid Equipment | 2345 Fenton Pkwy, San Diego, CA 92108-4743 | 2015-03-12 |
| 1457780819 | Monica B Kim | Pharmacist | 2345 Fenton Pkwy, San Diego, CA 92108-4743 | 2013-11-06 |
| 1558634287 | Wendy Lam | Pharmacist | 2345 Fenton Pkwy, San Diego, CA 92108-4743 | 2012-02-10 |
| 1407131642 | Paul Nguyen | Pharmacist | 2345 Fenton Pkwy, San Diego, CA 92108-4743 | 2011-10-19 |
| 1861633059 | Daniel Alexander Serritella | Pharmacist | 2345 Fenton Pkwy, San Diego, CA 92108-4743 | 2009-03-17 |
| 1154474195 | Robyn Dee Slikker | Optometrist | 2345 Fenton Pkwy, San Diego, CA 92108-4743 | 2007-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902801 | Keri Castaneda | Behavior Technician | 025 Camino Del Rio South Suite 101, San Diego, CA 92108 | 2020-11-06 |
| 1457963738 | Diyana Giorgees | Case Manager/Care Coordinator | 5005 Texas Street, St. 203, San Diego, CA 92108 | 2020-08-19 |
| 1780211896 | Lori Mildred Jerman | Marriage & Family Therapist | Healthy Minds Counseling Services, 1455 Frazee Road, Suite 880, San Diego, CA 92108 | 2020-03-26 |
| 1285260737 | Demetrius Anderson | Counselor | Telecare Corporation Ihot, 1660 Hotel Circle North, Suite 101, San Deigo, CA 92108 | 2020-03-17 |
| 1033742465 | Dasc Medical Inc | Durable Medical Equipment & Medical Supplies | 5520 Gill Village Way, 907, San Diego, CA 92108 | 2020-02-13 |
| 1508401092 | Chanda Denee Kizer | Marriage & Family Therapist | 3517 Camino Del Rio N, Suite 407, San Diego, CA 92108 | 2019-11-08 |
| 1225695562 | Jenna Rose Shurer | Nurse Practitioner | 5030 Camino De La Siesla Ste 106, San Diego, CA 92108 | 2019-05-22 |
| 1952967812 | Martha Kebede Mekonen | Chiropractor | 2667 Camino Del Rio South, Suite #313, San Diego, CA 92108 | 2019-05-16 |
| 1053886135 | Andrea Jiselly Munoz | Behavior Technician | 3505 Camino Del Rio South, Suite 200, San Diego, CA 92108 | 2018-10-04 |
| 1386128916 | Sarah Elisabeth Smith | Counselor | 7575 Metropolitan Dr., San Diego, CA 92108 | 2018-09-19 |
| Find all providers in zip 92108 | ||||
| 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 |
|---|---|---|---|---|
| 1124545454 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 4465 La Jolla Village Dr Ste H-5, San Diego, CA 92122-1218 | 2017-08-28 |
| 1114478187 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 7017 Friars Rd, San Diego, CA 92108-1129 | 2016-10-14 |
| 1174882294 | Rachelle Marie Keltner, An Optometry Corp | Eyewear Supplier (Equipment, not the service) | 7875 Highland Village Pl, Ste. B-102, San Diego, CA 92129-5189 | 2012-05-09 |
| 1023208287 | Essilor Laboratories of America, Inc | Eyewear Supplier (Equipment, not the service) | 9560 Ridgehaven Ct, San Diego, CA 92123-1668 | 2007-07-25 |
| 1730228305 | For Eyes Optical of Ca | Eyewear Supplier (Equipment, not the service) | 3689 Midway Dr, Suite D, San Diego, CA 92110-5265 | 2007-02-06 |
| 1962556902 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 1640 Camino Del Rio N, Mission Valley Ctr Ste #200, San Diego, CA 92108-1506 | 2007-01-23 |
| 1306996673 | Cole Vision Corporation | Eyewear Supplier (Equipment, not the service) | 8730 Rio San Diego Dr, San Diego, CA 92108-5500 | 2007-01-11 |
| 1528118833 | Cole Vision Corporation | Eyewear Supplier (Equipment, not the service) | 12080 Carmel Mountain Rd, San Diego, CA 92128-4605 | 2007-01-11 |
| 1174673495 | Cole Vision Corporation | Eyewear Supplier (Equipment, not the service) | 7655 Clairemont Mesa Blvd, Sears Essentials, San Diego, CA 92111-1534 | 2007-01-11 |
| 1760547731 | Pearle Visioncare, Inc | Eyewear Supplier (Equipment, not the service) | 4595 Clairemont Dr, Clairemont, San Diego, CA 92117-5540 | 2006-12-27 |
| Find all providers in SAN DIEGO | ||||
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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.