Organization · Type 2 NPI

Costco Wholesale Corporation

Eyewear Supplier · Tallahassee, FL

NPI number 1134513013 Active

Practice location

4067 Lagniappe Way
Tallahassee, FL 32317-1201

Call (850) 219-2511 Map

Fax (850) 219-2504

Mailing address

PO Box 35005
Seattle, WA 98124-3405

Specialties and licenses

Taxonomy	Code	License
Eyewear Supplier Primary	332H00000X	OE1674 (FL)

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

5 other providers at this address

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NPI record

NPI: 1134513013
Entity type: Organization (Type 2)
Issued: Mar 27, 2015
Last updated: Jun 4, 2020
Status: Active
Subpart: Yes of Costco Wholesale Corporation

Other names

<unavail>
Costco Optical #1026 · doing business as
Costco Optical #1026 · doing business as

Authorized official

Art Salas
AVP Optical
(850) 219-2511

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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 1134513013

Costco Wholesale Corporation's National Provider Identifier is 1134513013, issued on Mar 27, 2015. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Tallahassee, FL. The record was last updated on Jun 4, 2020.