Provider Demographics
NPI:1275916959
Name:CARIBE PHARMACY HOLDINGS, LLC
Entity Type:Organization
Organization Name:CARIBE PHARMACY HOLDINGS, LLC
Other - Org Name:FARMACIA CARIDAD #29
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP PHARMACY OPERATIONS
Authorized Official - Prefix:
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:879-367-4397
Practice Address - Street 1:374 AVE PONCE DE LEON
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2024
Practice Address - Country:US
Practice Address - Phone:787-766-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4029206OtherNCPDP
PR6365390021Medicare NSC
VAFA734Medicare PIN