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Costco Wholesale Corporation — NPI 1619367307, Santa Rosa, CA | NPI Central

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NPI 1619367307

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Costco Wholesale Corporation

NPI 1619367307 · Eyewear Supplier · Santa Rosa, CA

Provider details

NPI number: 1619367307
Entity type: Organization
Primary specialty: Eyewear SupplierSuppliers
Parent organization: Costco Wholesale Corporation
Organization subpart: Yes
Authorized official: Art Salas, Avp Optical(707) 578-7497
License: D6121 (CA)

Specialties & taxonomies

Eyewear SupplierPrimary332H00000XLicense D6121 (CA)
Suppliers

Practice location

1900 Santa Rosa Ave

Santa Rosa, CA 95407-7621

Phone: (707) 578-7497

Fax: (707) 566-6422

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 #41
Doing business as: Costco Optical #41

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.