Provider Demographics
NPI:1699740134
Name:KNUEPPEL HEALTHCARE SERVICES, INC.
Entity type:Organization
Organization Name:KNUEPPEL HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CIARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-258-2800
Mailing Address - Street 1:1143 WARWICK WAY
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53406-5661
Mailing Address - Country:US
Mailing Address - Phone:262-321-0110
Mailing Address - Fax:262-321-0212
Practice Address - Street 1:1143 WARWICK WAY
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53406-5661
Practice Address - Country:US
Practice Address - Phone:262-321-0110
Practice Address - Fax:262-321-0212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-20
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41695200Medicaid
WI41695200Medicaid