Organization · Type 2 NPI

Costco Wholesale Corporation

Eyewear Supplier · Rancho Cucamonga, CA

NPI number 1043609506 Active

Practice location

11800 4th St
Rancho Cucamonga, CA 91730-6129

Call (909) 581-1701 Map

Fax (909) 581-1717

Mailing address

PO Box 35005
Seattle, WA 98124-3405

Specialties and licenses

Taxonomy	Code	License
Eyewear Supplier Primary	332H00000X	D6856 (CA)

Eyewear Supplier: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

9 other providers at this address

Other eyewear supplier providers in Rancho Cucamonga

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NPI record

NPI: 1043609506
Entity type: Organization (Type 2)
Issued: Jan 21, 2015
Last updated: Jun 11, 2020
Status: Active
Subpart: Yes of Costco Wholesale Corporation

Other names

<unavail>
Costco Optical #678 · doing business as
Costco Optical #678 · doing business as

Authorized official

Art Salas
AVP Optical
(909) 581-1701

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1043609506

Costco Wholesale Corporation's National Provider Identifier is 1043609506, issued on Jan 21, 2015. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Rancho Cucamonga, CA. The record was last updated on Jun 11, 2020.