Healthcare Provider Details

I. General information

NPI: 1518323039
Provider Name (Legal Business Name): CARIBE PHARMACY MANEGMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2016
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 2 KM 54.6 INTERIOR PRIME OUTLETS BOULEVARD LOCAL 2
BARCELONETA PR
00617
US

IV. Provider business mailing address

PO BOX 4218
BAYAMON PR
00958-1218
US

V. Phone/Fax

Practice location:
  • Phone: 787-786-6385
  • Fax: 787-966-7299
Mailing address:
  • Phone: 787-787-7733
  • Fax: 787-269-0022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier2157454
Identifier TypeOTHER
Identifier State
Identifier IssuerPK
# 2
Identifier039499100
Identifier TypeMEDICAID
Identifier StatePR
Identifier Issuer

VIII. Authorized Official

Name: JORGE VARGAS
Title or Position: VP PHARMACY OPERATIONS
Credential:
Phone: 787-638-0638