Healthcare Provider Details

I. General information

NPI: 1073248167
Provider Name (Legal Business Name): CARIBE PHARMACY HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2022
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

668 CALLE CUBITAS
GUAYNABO PR
00969-2801
US

IV. Provider business mailing address

PO BOX 4218
BAYAMON PR
00958-1218
US

V. Phone/Fax

Practice location:
  • Phone: 787-787-7733
  • Fax:
Mailing address:
  • Phone: 787-787-7733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. JORGE A VARGAS
Title or Position: VP PHARMACY OPERATIONS
Credential:
Phone: 787-787-7733