OrganizationActive
Costco Wholesale Corporation
NPI 1457741142 · Eyewear Supplier · Roseville, CA
Provider details
- NPI number
- 1457741142
- Entity type
- Organization
- Primary specialty
- Eyewear SupplierSuppliers
- Parent organization
- Costco Wholesale Corporation
- Organization subpart
- Yes
- Authorized official
- Art Salas, Avp Optical(916) 789-1368
- License
- D6120 (CA)
Specialties & taxonomies
Suppliers
Practice location
6750 Stanford Ranch Rd
Roseville, CA 95678-1907
Phone: (916) 789-1368
Fax: (916) 789-1999
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 35005
Seattle, WA 98124-3405
Other names (DBA / former)
- Doing business as
- Costco Optical #29
- Doing business as
- Costco Optical #29
Registry dates
- Enumerated
- 2015-02-02
- Last updated
- 2020-06-05
- Certified
- 2020-06-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.