Organization · Type 2 NPI

Costco Wholesale Corporation

Eyewear Supplier · Fountain Valley, CA

NPI number 1063801918 Active

Practice location

17900 Newhope St
Fountain Valley, CA 92708-5422

Call (714) 338-2188 Map

Fax (714) 434-1309

Mailing address

PO Box 35005
Seattle, WA 98124-3405

Specialties and licenses

Taxonomy	Code	License
Eyewear Supplier Primary	332H00000X	D6822 (CA)

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

11 other providers at this address

Other eyewear supplier providers in Fountain Valley

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NPI record

NPI: 1063801918
Entity type: Organization (Type 2)
Issued: Jan 15, 2015
Last updated: Jun 11, 2020
Status: Active
Subpart: Yes of Costco Wholesale Corporation

Other names

<unavail>
Costco Optical #411 · doing business as
Costco Optical #411 · doing business as

Authorized official

Art Salas
AVP Optical
(714) 338-2188

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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 1063801918

Costco Wholesale Corporation's National Provider Identifier is 1063801918, issued on Jan 15, 2015. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Fountain Valley, CA. The record was last updated on Jun 11, 2020.