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

Costco Wholesale Corporation

Organization Community/Retail Pharmacy · NPI 1093825622

Costco Wholesale Corporation is a Community/Retail Pharmacy in Southlake, Texas. Licensed in Texas. Registered with an NPI since 2006.

Licensed in
TX
In the registry since
2006

Practice location Address checks out

2601 E State Highway 114
Southlake, TX 76092
Phone: (817) 749-2802
Fax: (817) 749-2820
Show map & directions

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

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence 20770 (TX)

Record details

NPI number1093825622
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Richard Stephens — Svp · (425) 313-8259
Other names Costco Pharmacy #669
NPI enumeratedAugust 30, 2006
Last updated in NPPESMay 14, 2024
Certification dateMay 14, 2024
Mailing addressPo Box 34300, Seattle, WA 98124-1300

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