Organization · Type 2 NPI

Costco Wholesale Corporation

Eyewear Supplier · Pembroke Pines, FL

NPI number 1063806941 Active

Practice location

15915 Pines Blvd
Pembroke Pines, FL 33027-1201

Call (954) 266-3460 Map

Fax (954) 266-3482

Mailing address

PO Box 35005
Seattle, WA 98124-3405

Specialties and licenses

Taxonomy	Code	License
Eyewear Supplier Primary	332H00000X	OE1416 (FL)

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

8 other providers at this address

Other eyewear supplier providers in Pembroke Pines

See all in Pembroke Pines →

NPI record

NPI: 1063806941
Entity type: Organization (Type 2)
Issued: Mar 27, 2015
Last updated: Apr 7, 2020
Status: Active
Subpart: Yes of Costco Wholesale Corporation

Other names

<unavail>
Costco Optical #742 · doing business as
Costco Optical #742 · doing business as

Authorized official

Art Salas
AVP Optical
(954) 266-3463

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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 1063806941

Costco Wholesale Corporation's National Provider Identifier is 1063806941, issued on Mar 27, 2015. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Pembroke Pines, FL. The record was last updated on Apr 7, 2020.