Healthcare Provider Details

I. General information

NPI: 1134603012
Provider Name (Legal Business Name): CARIBE PHARMACY MANEGMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 2 KM 7.1 SANTA ROSA MALL LOCAL 24
BAYAMON PR
00959
US

IV. Provider business mailing address

PO BOX 4218
BAYAMON PR
00958-1218
US

V. Phone/Fax

Practice location:
  • Phone: 787-786-6306
  • Fax:
Mailing address:
  • Phone: 787-787-7733
  • Fax: 787-269-0022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
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
Identifier039599400
Identifier TypeMEDICAID
Identifier StatePR
Identifier Issuer

VIII. Authorized Official

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