| Organization Name: | COSTCO WHOLESALE CORPORAITON |
| NPI Number: | 1063802577 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ART SALAS (AVP OPTICAL) |
| Mailing Address: | 2440 Daniels St Manteca |
| State: | CA US |
| Postal Code: | 953376745 |
| Phone Number: | 2098258200 |
| Fax Number: | 2098258204 |
| NPI Enumeration Date: | 02/04/2015 |
| NPI Last Update Date: | 04/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332H00000X |
| License Number: | D7345 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |