Organization · Type 2 NPI

Costco Wholesale Corporation

Eyewear Supplier · Fontana, CA

NPI number 1427447994 Active

Practice location

16505 Sierra Lakes Pkwy
Fontana, CA 92336-1256

Call (909) 770-5651 Map

Fax (909) 770-5650

Mailing address

PO Box 35005
Seattle, WA 98124-3405

Specialties and licenses

Taxonomy	Code	License
Eyewear Supplier Primary	332H00000X	D7227 (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 Fontana

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NPI record

NPI: 1427447994
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 #627 · doing business as
Costco Optical #627 · doing business as

Authorized official

Art Salas
AVP Optical
(909) 770-5650

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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 1427447994

Costco Wholesale Corporation's National Provider Identifier is 1427447994, issued on Jan 21, 2015. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Fontana, CA. The record was last updated on Jun 12, 2020.