Organization · Type 2 NPI

Costco Wholesale Corporation

Community/Retail Pharmacy · Eastvale, CA

NPI number 1053815977 Active

Practice location

5030 Hamner Ave.
Eastvale, CA 91752

Call (951) 749-7192 Map

Fax (951) 749-7183

Mailing address

PO Box 34300
Seattle, WA 98124-1300

Specialties and licenses

Taxonomy	Code	License
Community/Retail Pharmacy Primary	3336C0003X	None listed

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 …

2 other providers at this address

Other community/retail pharmacy providers in Eastvale

See all in Eastvale →

NPI record

NPI: 1053815977
Entity type: Organization (Type 2)
Issued: Mar 23, 2018
Last updated: May 21, 2025
Status: Active
Subpart: Yes of Costco Wholesale Corporation

Other names

<unavail>
Costco Pharmacy #1317 · doing business as
Costco Pharmacy #1317 · doing business as

Authorized official

Richard Stephens
SVP Pharmacy
(425) 313-8259

Verify this record

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.

Is this your record? How to update it.

About NPI 1053815977

Costco Wholesale Corporation's National Provider Identifier is 1053815977, issued on Mar 23, 2018. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Eastvale, CA. The record was last updated on May 21, 2025.