Healthcare Provider Details

I. General information

NPI: 1356619928
Provider Name (Legal Business Name): SG BLOOD SAVER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2011
Last Update Date: 12/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL DE LA CONCEPCION CARR 2 KM 173.4 BO CAIN ALTO
SAN GERMAN PR
00683
US

IV. Provider business mailing address

PO BOX 66
SAN GERMAN PR
00683-0066
US

V. Phone/Fax

Practice location:
  • Phone: 787-892-1860
  • Fax: 787-892-6972
Mailing address:
  • Phone: 787-892-1860
  • Fax: 787-892-6972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code331L00000X
TaxonomyBlood Bank
License Number5563
License Number StatePR

VIII. Authorized Official

Name: JOSE C NAVARRO
Title or Position: PRESIDENT
Credential:
Phone: 787-892-6972