Provider Demographics
NPI:1649402967
Name:CARIBE PATIENT SERVICES,LLC
Entity Type:Organization
Organization Name:CARIBE PATIENT SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:340-774-8819
Mailing Address - Street 1:PO BOX 9518
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-2518
Mailing Address - Country:US
Mailing Address - Phone:340-774-8819
Mailing Address - Fax:340-774-9051
Practice Address - Street 1:9149 ESTATE THOMAS
Practice Address - Street 2:SUITE 304
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-2615
Practice Address - Country:US
Practice Address - Phone:340-774-8819
Practice Address - Fax:340-774-9051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI100946261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical