COSTCO WHOLESALE CORPORATION (NPI# 1609986231) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609986231 |
| Entity Type | Organization |
| Organization Name | COSTCO WHOLESALE CORPORATION |
| Other Organization Name | COSTCO PHARMACY # 204 |
| Practice Address |
4725 W Ox Rd Fairfax VA 22030-6125 |
| Mailing Address |
Po Box 34300 Seattle WA 98124-1300 |
| Practice Telephone | 7038021229 |
| Practice Fax Number | 7033323221 |
| Mailing Telephone | 4253136670 |
| Mailing Fax Number | 4253136595 |
| Enumeration Date | 2006-08-30 |
| 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 |
0201003261 | VA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 4829000 | 01 |
| Other Name | Type Code |
|---|---|
| COSTCO PHARMACY # 204 | 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 |
4725 W OX RD |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030-6125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245616879 | Van Huynh | Pharmacist | 4725 W Ox Rd, Fairfax, VA 22030-6125 | 2015-08-05 |
| 1841686425 | Costco Wholesale Corporation | Hearing Aid Equipment | 4725 W Ox Rd, Fairfax, VA 22030-6125 | 2015-04-10 |
| 1184018418 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 4725 W Ox Rd, Fairfax, VA 22030-6125 | 2015-03-25 |
| 1902164478 | Karen R Mulheron | Pharmacist | 4725 W Ox Rd, Fairfax, VA 22030-6125 | 2012-05-02 |
| 1790054658 | Susan Mathews | Pharmacist | 4725 W Ox Rd, Fairfax, VA 22030-6125 | 2011-12-22 |
| 1275819765 | Anita Narasimhan | Pharmacist | 4725 W Ox Rd, Fairfax, VA 22030-6125 | 2011-10-27 |
| 1447535604 | Nathan Nghia Hoang | Pharmacist | 4725 W Ox Rd, Fairfax, VA 22030-6125 | 2011-10-19 |
| 1457500647 | Scott Alan Macdonald | Optometrist | 4725 W Ox Rd, Fairfax, VA 22030-6125 | 2008-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205449477 | Perry Camp Jr. | Psychologist | 4403 Dixie Hill Rd, Unit 205, Fairfax, VA 22030 | 2020-08-28 |
| 1952940322 | Brightview Fair Oaks, LLC | Alzheimer Center (Dementia Center) | 12725 Lee Highway, Fairfax, VA 22030 | 2020-01-02 |
| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
| 1497221303 | Kahak, Inc. | Day Training, Developmentally Disabled Services | 10560 Main Street Suite Ps100, Fairfax, VA 22030 | 2018-10-17 |
| 1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1275033607 | Philajo Global LLC | Non-emergency Medical Transport (VAN) | 4521 Billingham Street, Fairfax, VA 22030 | 2018-02-12 |
| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| 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 |
|---|---|---|---|---|
| 1417411414 | District Rx LLC | Pharmacy | 8301 Arlington Blvd Ste 107, Fairfax, VA 22031-2902 | 2019-01-24 |
| 1194240077 | Qurex Pharmacy | Pharmacy | 3949 Pender Dr Ste 130, Fairfax, VA 22030-6033 | 2017-08-11 |
| 1942689609 | Medex Health Group LLC | Pharmacy | 3023 Hamaker Ct Ste Ll110, Fairfax, VA 22031-2630 | 2015-05-27 |
| 1598093627 | Harris Teeter, LLC | Pharmacy | 3905 Fair Ridge Dr, Fairfax, VA 22033-2906 | 2009-12-01 |
| 1649378100 | Virginia Cvs Pharmacy LLC | Pharmacy | 10090 Fairfax Blvd, Fairfax, VA 22030-1741 | 2006-09-20 |
| 1598869257 | Virginia Cvs Pharmacy LLC | Pharmacy | 10390 Willard Way, Fairfax, VA 22030-2508 | 2006-09-12 |
| 1619071370 | Virginia Cvs Pharmacy, L.L.C. | Pharmacy | 13031 Lee Jackson Memorial Hwy, Fairfax, VA 22033-2048 | 2006-09-12 |
| 1255434809 | Harris Teeter, Inc. | Pharmacy | 10320 Main St, Fairfax, VA 22030-2410 | 2006-09-07 |
| 1275572620 | Bjs Wholesale Club Inc | Pharmacy | 13053 Fair Lakes Shopping Ctr, Fairfax, VA 22033-5179 | 2006-06-04 |
| 1942250816 | Fairfax Pharmacy Inc. | Pharmacy | 1275 Allendale Fairfax Hwy, Fairfax, SC 29827-9124 | 2006-05-11 |
| Find all providers in FAIRFAX | ||||
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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.