Provider Demographics
NPI:1518355320
Name:CARIBE PHARMACY MANEGMENT LLC
Entity Type:Organization
Organization Name:CARIBE PHARMACY MANEGMENT LLC
Other - Org Name:PHARMAMAX MAYAGUEZ 2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RX DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:DIAZ
Authorized Official - Last Name:SALICRUP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-232-8734
Mailing Address - Street 1:PO BOX 6842 270 CALLE DE LA CANDELARIA
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-808-1586
Mailing Address - Fax:787-808-1588
Practice Address - Street 1:CARR #2 KM 149.5
Practice Address - Street 2:BO. SABANETAS
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-832-5555
Practice Address - Fax:787-832-5505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-31
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR18F32393336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2149343OtherPK