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COSTCO PHARMACY #1222
NPI 1902280092
Pharmacy - Community/Retail Pharmacy in Grand Chute, WI

Active since July 17, 2015
5401 W INTEGRITY WAY, GRAND CHUTE, WI 54913(920) 363-7010(920) 363-7001 Get Directions Write a Review

NPPES record last updated: February 7, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 7, 2024, Jul 23, 2018 (2 updates tracked since 2018).

About Costco Pharmacy #1222 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COSTCO PHARMACY #1222 (NPI 1902280092) is a healthcare organization registered as a community/retail pharmacy in Grand Chute, Wisconsin and active in the NPI registry since July 2015. The organization lists Richard Stephens, Svp Pharmacy, as its authorized official.

NPPES Registry Identity

NPI1902280092
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameCOSTCO WHOLESALE CORPORATION
Location Address5401 W INTEGRITY WAYGrand Chute, WI 54913
Mailing AddressPo Box 34300Seattle, WA 98124-1300
Phone(920) 363-7010
Fax(920) 363-7001
Organization SubpartNo
Authorized OfficialRichard StephensSvp Pharmacy · (425) 313-7825
Enumeration DateJuly 17, 2015
Last NPPES UpdateFebruary 7, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 7, 2024
✔ NPI 1902280092 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in WI · 9346-42
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
5401 W INTEGRITY WAY, Grand Chute, WI 54913
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Other Names 1

Doing Business AsCostco Pharmacy #1222

Other Identifiers 1

Other2153719Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
292 services291 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
286 services286 patients
Severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5ml dosage, for intramuscular use 91304
The COVID-19 vaccine you'll receive is designed to protect against the virus. It contains tiny, harmless pieces of the virus's spike protein. These trigger your immune system to build a defense. The vaccine also includes a saponin-based adjuvant to enhance this response. It's given as a 0.5ml injection into a muscle.
13 services12 patients

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAYLA ANN STANKOWSKI JOHNSON LAT, ATC
Specialist/Technologist (Athletic Trainer)
5401 W INTEGRITY WAY
APPLETON, WI 54913
Outagamie County (844) 274-6849
JORDAN GODDARD PHARM.D
Pharmacist
5401 W INTEGRITY WAY
APPLETON, WI 54913
Outagamie County (920) 815-4510

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Costco Wholesale Corporation's NPI number?

The NPI number for Costco Wholesale Corporation is 1902280092. It was assigned to this organization in the NPPES registry on July 17, 2015. The provider is doing business as Costco Pharmacy #1222.

Where is Costco Wholesale Corporation located?

Costco Wholesale Corporation is located at 5401 W Integrity Way, Grand Chute, WI 54913. The listed phone number is (920) 363-7010.

What is Costco Wholesale Corporation's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

What insurance does Costco Wholesale Corporation accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 51 other insurers list Costco Wholesale Corporation as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Costco Wholesale Corporation was last updated on February 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.