Organization · Type 2 NPI

Costco Wholesale Corporation

Eyewear Supplier · Moreno Valley, CA

NPI number 1265821730 Active

Practice location

12700 Day St
Moreno Valley, CA 92553-7521

Call (951) 697-8900 Map

Fax (951) 697-8901

Mailing address

PO Box 35005
Seattle, WA 98124-3405

Specialties and licenses

Taxonomy	Code	License
Eyewear Supplier Primary	332H00000X	D6839 (CA)

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

6 other providers at this address

Other eyewear supplier providers in Moreno Valley

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NPI record

NPI: 1265821730
Entity type: Organization (Type 2)
Issued: Jan 21, 2015
Last updated: Jun 12, 2020
Status: Active
Subpart: Yes of Costco Wholesale Corporation

Other names

<unavail>
Costco Optical #455 · doing business as
Costco Optical #455 · doing business as

Authorized official

Art Salas
AVP Optical
(951) 697-8900

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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 1265821730

Costco Wholesale Corporation's National Provider Identifier is 1265821730, issued on Jan 21, 2015. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Moreno Valley, CA. The record was last updated on Jun 12, 2020.