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	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	4027048	OTHER	NCPDP - OTHER COMMERCIAL IDENTIFIER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467789552
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	:	105 GILBERTO CONCEPCION DE GRACIA
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00901-2712
Country	:	US
Telephone Number	:	787-725-2500
Fax Number	:

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

Provider Enumeration Date	:	11/10/2009
Last Update Date	:	12/08/2025

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