Provider Demographics
NPI:1619375268
Name:CARIB SUPPLY ST. CROIX INC.
Entity type:Organization
Organization Name:CARIB SUPPLY ST. CROIX INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAXWELL
Authorized Official - Middle Name:CLEMENT
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:340-778-6427
Mailing Address - Street 1:3 CASAVA GDNS
Mailing Address - Street 2:HESS ROAD
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820-5682
Mailing Address - Country:US
Mailing Address - Phone:340-778-6427
Mailing Address - Fax:340-778-6749
Practice Address - Street 1:3 CASSAVA GARDEN, HESS ROAD
Practice Address - Street 2:CARIB SUPPLY
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00822
Practice Address - Country:US
Practice Address - Phone:340-778-6427
Practice Address - Fax:340-778-6749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-15
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI2-3441-1L332900000X
VI2-3441-L332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332900000XSuppliersNon-Pharmacy Dispensing Site