Provider Demographics
NPI:1326200338
Name:COPPE HEALTHCARE SOLUTIONS
Entity Type:Organization
Organization Name:COPPE HEALTHCARE SOLUTIONS
Other - Org Name:WISCONSIN VIRAL RESEARCH GROUP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KONSTANCE
Authorized Official - Middle Name:KEHL
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:262-574-0701
Mailing Address - Street 1:W229 N1870 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186
Mailing Address - Country:US
Mailing Address - Phone:262-574-0701
Mailing Address - Fax:262-574-0703
Practice Address - Street 1:W229 N1870 WESTWOOD DR
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186
Practice Address - Country:US
Practice Address - Phone:262-574-0701
Practice Address - Fax:262-574-0703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory