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COSTCO WHOLESALE CORPORATION NPI 1164532776


NPI Information

NPI: 1164532776
Provider Name: COSTCO WHOLESALE CORPORATION

Doing Business As: COSTCO PHARMACY # 187

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
3980 VENTURE DR
DULUTH, GA
ZIP 30096
Phone: (770) 622-1330
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COSTCO WHOLESALE CORPORATION is a community/retail pharmacy pharmacy in Duluth, GA. The provider is 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. COSTCO WHOLESALE CORPORATION NPI is 1164532776. The provider is registered as an organization entity type.
The provider Is Doing Business As Costco Pharmacy # 187.

The provider's business location address is:

3980 VENTURE DR
DULUTH, GA
ZIP 30096-077
Phone: (770) 622-1330
Fax: (770) 622-1320

The provider's authorized official is Michael Mastromonica .
The authorized official title is Avp Pharmacy and has the following contact phone number (425) 313-2892.

The enumeration date for this NPI number is 8/30/2006 and was last updated on 8/18/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail Pharmacy8041GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1PHC067MEDICARE PIN
21143180OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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