Provider Demographics
NPI:1992286074
Name:RPRD DIAGNOSTICS LLC
Entity type:Organization
Organization Name:RPRD DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ULRICH
Authorized Official - Middle Name:
Authorized Official - Last Name:BROECKEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-771-9888
Mailing Address - Street 1:1225 DISCOVERY PARKWAY, SUITE 260
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226
Mailing Address - Country:US
Mailing Address - Phone:414-316-3101
Mailing Address - Fax:414-777-0058
Practice Address - Street 1:1225 DISCOVERY PARKWAY, SUITE 260
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226
Practice Address - Country:US
Practice Address - Phone:414-316-3101
Practice Address - Fax:414-777-0058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory