Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Costco Wholesale Corporation

Organization Eyewear Supplier · NPI 1063803807

Costco Wholesale Corporation is an Eyewear Supplier in Maple Grove, Minnesota. Registered with an NPI since 2015.

In the registry since
2015

Practice location Address checks out

11330 Fountains Dr
Maple Grove, MN 55369-7200
Phone: (763) 494-8050
Fax: (763) 494-8054
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Eyewear Supplier (primary) Taxonomy 332H00000X

Record details

NPI number1063803807
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCostco Wholesale Corporation
Authorized official Art Salas — Avp Optical · (763) 494-8061
Other names Costco Optical #648; Costco Optical #648
NPI enumeratedFebruary 16, 2015
Last updated in NPPESFebruary 27, 2020
Certification dateFebruary 27, 2020
Mailing addressPo Box 35005, Seattle, WA 98124-3405

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