Costco Pharmacy #638

LBN: Costco Wholesale Corporation
Costco Pharmacy #638 is an health care organization with primary practice located at 79795 Highway 111 , La Quinta CA 92253-4756. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Costco Wholesale Corporation can be contacted via phone (760) 342-0656, or through Mastromonica, Michael via phone (425) 313-2892.

Contact Information

Primary practice address
79795 Highway 111 La Quinta CA 92253-4756
Phone: (760) 342-0656
Fax: (760) 775-0367
Website:
Map and Directions
Authorized official contact:
Name: Mastromonica, Michael
Phone: (425) 313-2892

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X PHY48311 California

Profile Details

NPI number 1164505202
LBN Legal business name Costco Wholesale Corporation
DBA Doing business as Costco Pharmacy #638
Authorized official Mastromonica, Michael
Entity Organization
Organization subpart 1 No
Enumeration date Oct 23rd, 2006
Last updated Aug 15th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164505202 NPPES
Other 5624259 NCPDP PROVIDER IDENTIFICATION NUMBER

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