1962009704 NPI number — CARIBE PHARMACY MANEGMENT LLC

Table of content: (NPI 1962009704)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962009704 NPI number — CARIBE PHARMACY MANEGMENT LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARIBE PHARMACY MANEGMENT LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962009704
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6842 270 CALLE DE LA CANDELARIA
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAYAGUEZ
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00680
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-899-1586
Provider Business Mailing Address Fax Number:
787-849-3688

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 107 KM 3.0 COMERCIAL BORINQUEN TOWER PLAZA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AGUADILLA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00603-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-658-7244
Provider Business Practice Location Address Fax Number:
787-658-7243
Provider Enumeration Date:
10/05/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SALICRUP
Authorized Official First Name:
JUDITH
Authorized Official Middle Name:
DIAZ
Authorized Official Title or Position:
RX DIRECTOR
Authorized Official Telephone Number:
787-232-8734

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)