Provider Demographics
NPI:1750793568
Name:EMPRESAS CAROLIMAR INCORPORADO
Entity type:Organization
Organization Name:EMPRESAS CAROLIMAR INCORPORADO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MILDRED
Authorized Official - Middle Name:I
Authorized Official - Last Name:RIVERA CRESPO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:787-403-9141
Mailing Address - Street 1:PO BOX 3682 HATO ARRIBA STA
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-7012
Mailing Address - Country:US
Mailing Address - Phone:787-403-9141
Mailing Address - Fax:787-827-0344
Practice Address - Street 1:#72 AVE MATIAS BRUGMAN
Practice Address - Street 2:
Practice Address - City:LAS MARIAS
Practice Address - State:PR
Practice Address - Zip Code:00670-2005
Practice Address - Country:US
Practice Address - Phone:787-827-0747
Practice Address - Fax:787-827-0344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20-F-31993336C0003X
333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR037929000Medicaid
2145963OtherPK