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

Costco Wholesale Corporation

Organization Pharmacy · NPI 1891140091

Costco Wholesale Corporation is a Pharmacy in LA Vista, Nebraska. Licensed in Nebraska. Registered with an NPI since 2016.

Licensed in
NE
In the registry since
2016
Specialties on file
2

Practice location Address checks out

12515 Portside Pkwy
LA Vista, NE 68128-8224
Phone: (402) 378-7408
Fax: (402) 378-7399
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 678 (NE)
Pharmacy Taxonomy 333600000X

Record details

NPI number1891140091
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Richard Stephens — Agmm Third Party · (425) 313-8259
Other names Costco Pharmacy #1237
NPI enumeratedApril 26, 2016
Last updated in NPPESMay 27, 2025
Certification dateMay 27, 2025
Mailing addressPo Box 34300, Seattle, WA 98124-1300

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