Provider Demographics
NPI:1942743208
Name:CARIBE PHARMACY MANEGMENT LLC
Entity Type:Organization
Organization Name:CARIBE PHARMACY MANEGMENT LLC
Other - Org Name:PHARMAMAX SAN SEBASTIAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RX DIRECTOR
Authorized Official - Prefix:MRS
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:787-896-4141
Mailing Address - Fax:787-849-3688
Practice Address - Street 1:AVE 111 KM 18.7
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00667
Practice Address - Country:US
Practice Address - Phone:787-896-4141
Practice Address - Fax:787-849-3688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-18
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18F3413302F00000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2005916OtherLICENCIA CONSERVACION Y REGISTRO DE PRODUCTOS BIOLOGICOS
PR18F3413OtherLICENCIA DEPARTAMENTO DE SALUD PUERTO RICO