MEDICARE: CARIBE PHARMACY MANAGEMENT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4029600	OTHER	PR	NCPDP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194268482
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARIBE PHARMACY MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	PO BOX 4218
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00958-1218
Country	:	US
Telephone Number	:	787-787-7733
Fax Number	:	787-936-7439

Provider Business Practice Location Address
First Line	:	8030 CALLE TARTAK
Second Line	:
City	:	CAROLINA
State	:	PR
Zip	:	00979-5802
Country	:	US
Telephone Number	:	787-641-0153
Fax Number	:

Authorized Official
Title or Position	:	VP PHARMACY OPERATIONS
Name	:	JORGE VARGAS
Credential	:
Telephone Number	:	787-638-0638

Provider Enumeration Date	:	11/18/2016
Last Update Date	:	12/08/2025

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