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Costco Wholesale Corporation — NPI 1457741142, Roseville, CA | NPI Central

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NPI 1457741142

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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

Eyewear SupplierPrimary332H00000XLicense D6120 (CA)
Suppliers

Practice location

6750 Stanford Ranch Rd

Roseville, CA 95678-1907

Phone: (916) 789-1368

Fax: (916) 789-1999

Approximate (ZIP-level) locationGet directions

More CA providers

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.