Provider Demographics
NPI:1619014792
Name:COQUI BLOOD SALVAGE INC
Entity Type:Organization
Organization Name:COQUI BLOOD SALVAGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-448-2931
Mailing Address - Street 1:CALLE AGUILA
Mailing Address - Street 2:# 112 BOSQUE VERDE
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-6985
Mailing Address - Country:US
Mailing Address - Phone:787-448-2931
Mailing Address - Fax:787-744-8359
Practice Address - Street 1:112 CALLE AGUILA
Practice Address - Street 2:BOSQUE VERDE
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-6985
Practice Address - Country:US
Practice Address - Phone:787-448-2931
Practice Address - Fax:787-744-8359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR168488247200000X
332B00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty