Organization · Type 2 NPI

Costco Wholesale Corporation

Community/Retail Pharmacy · Traverse City, MI

NPI number 1154840346 Active

Practice location

125 E South Airport Rd
Traverse City, MI 49686

Call (231) 252-7010 Map

Fax (231) 252-7001

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 Traverse City

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NPI record

NPI: 1154840346
Entity type: Organization (Type 2)
Issued: Sep 19, 2017
Last updated: May 22, 2025
Status: Active
Subpart: Yes of Costco Wholesale Corporation

Other names

<unavail>
Costco Pharmacy #1279 · doing business as
Costco Pharmacy #1279 · 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.

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About NPI 1154840346

Costco Wholesale Corporation's National Provider Identifier is 1154840346, issued on Sep 19, 2017. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Traverse City, MI. The record was last updated on May 22, 2025.