Provider Demographics
NPI:1508497207
Name:VARGAS, CARLOS D (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:D
Last Name:VARGAS
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:MR
Other - First Name:CARLOS
Other - Middle Name:D
Other - Last Name:VARGAS MARIANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 832
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-0832
Mailing Address - Country:US
Mailing Address - Phone:787-618-3348
Mailing Address - Fax:
Practice Address - Street 1:165 CALLE SAN FELIPE
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-4605
Practice Address - Country:US
Practice Address - Phone:787-878-1120
Practice Address - Fax:787-817-4678
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR00312183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR001312OtherPHARMACIST