Provider Demographics
NPI:1114082724
Name:CARIBE PHARMACY HOLDINGS, LLC
Entity Type:Organization
Organization Name:CARIBE PHARMACY HOLDINGS, LLC
Other - Org Name:FARMACIA CARIDAD #2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP PHARMACY OPERATIONS
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-787-7733
Mailing Address - Street 1:PO BOX 4218
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00958-1218
Mailing Address - Country:US
Mailing Address - Phone:787-787-7733
Mailing Address - Fax:787-747-3463
Practice Address - Street 1:#128 CALLE LUNA URB. LOS ANGELES CAROLINA
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979
Practice Address - Country:US
Practice Address - Phone:787-791-5757
Practice Address - Fax:787-253-3892
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARIBE PHARMACY HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-26
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-2012333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1076810003Medicare ID - Type Unspecified