NPI 1013322296 · live from the CMS NPI Registry
Costco Wholesale Corporation
Pharmacy, Community/Retail Pharmacy in South Jordan, UT. National Provider Identifier 1013322296, active.
NPI record
| NPI | 1013322296 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Community/Retail Pharmacy 3336C0003X |
| Practice location | 3571 W 10400 South, South Jordan, UT 84095 |
| Practice phone | 801-523-5297 |
| Mailing address | Po Box 34300, Seattle, WA 98124 |
| Enumerated | June 25, 2014 |
| Last updated | May 27, 2025 |
| Authorized official | Richard Stephens, Avp - Pharmacy Services |
| Other names | Costco Pharmacy #1019 |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacy, Community/Retail Pharmacy primary | 3336C0003X | 9112581-1703 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.