OrganizationActive
Costco Wholesale Corporation
NPI 1174912646 · Eyewear Supplier · San Bernardino, CA
Provider details
- NPI number
- 1174912646
- Entity type
- Organization
- Primary specialty
- Eyewear SupplierSuppliers
- Parent organization
- Costco Wholesale Corporation
- Organization subpart
- Yes
- Authorized official
- Art Salas, Avp Optical(909) 478-3445
- License
- D4126 (CA)
Specialties & taxonomies
Suppliers
Practice location
1099 E Hospitality Ln
San Bernardino, CA 92408-2813
Phone: (909) 478-3445
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 35005
Seattle, WA 98124-3405
Other names (DBA / former)
- Doing business as
- Costco Optical #478
- Doing business as
- Costco Optical #478
Registry dates
- Enumerated
- 2015-01-21
- Last updated
- 2020-06-12
- Certified
- 2020-06-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.