{
  "npi": "1548593908",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "RICHARD",
    "authorized_official_last_name": "STEPHENS",
    "authorized_official_telephone_number": "4253138259",
    "authorized_official_title_or_position": "SVP PHARMACY",
    "certification_date": "2025-05-20",
    "enumeration_date": "2009-09-16",
    "last_updated": "2025-05-20",
    "organization_name": "COSTCO WHOLESALE CORPORATION",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "301 HIGHLANDS BOULEVARD DR",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "MANCHESTER",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "636-686-7406",
      "postal_code": "63011",
      "state": "MO",
      "telephone_number": "636-686-7409"
    },
    {
      "address_1": "PO BOX 34300",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "SEATTLE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "425-313-6595",
      "postal_code": "981241300",
      "state": "WA",
      "telephone_number": "425-313-6670"
    }
  ],
  "taxonomies": [
    {
      "code": "3336C0003X",
      "desc": "Pharmacy, Community/Retail Pharmacy",
      "license": "2009034311",
      "primary": true,
      "state": "MO",
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": {
    "total_beneficiaries": "1231",
    "total_services": "3961",
    "total_medicare_allowed_amt": "297708.98",
    "top_hcpcs_services": [
      {
        "code": "90480",
        "description": "Admn sarscov2 vacc 1 dose",
        "services": "923",
        "beneficiaries": "847"
      },
      {
        "code": "90653",
        "description": "Influenza vaccine, inactivated",
        "services": "989",
        "beneficiaries": "989"
      },
      {
        "code": "90656",
        "description": "Influenza vaccine, trivalent, split virus, preservative-free, 0.5 ml dosage",
        "services": "30",
        "beneficiaries": "30"
      },
      {
        "code": "90677",
        "description": "Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use",
        "services": "32",
        "beneficiaries": "32"
      },
      {
        "code": "91304",
        "description": "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",
        "services": "30",
        "beneficiaries": "30"
      },
      {
        "code": "91320",
        "description": "Sarscv2 vac 30mcg trs-suc im",
        "services": "587",
        "beneficiaries": "555"
      },
      {
        "code": "91322",
        "description": "Sarscov2 vac 50 mcg/0.5ml im",
        "services": "306",
        "beneficiaries": "291"
      },
      {
        "code": "G0008",
        "description": "Administration of influenza virus vaccine",
        "services": "1025",
        "beneficiaries": "1023"
      }
    ]
  },
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "58",
        "medicare_type": "Medical Supply Company with Pharmacist"
      },
      {
        "medicare_code": "A5",
        "medicare_type": "Pharmacy"
      }
    ]
  }
}