Provider Demographics
NPI:1326531419
Name:ROSLEE UREY SOLE MBR
Entity Type:Organization
Organization Name:ROSLEE UREY SOLE MBR
Other - Org Name:ROSLEE UREY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSLEE
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:UREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-986-6238
Mailing Address - Street 1:22394 BUCKINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-5429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22934 BUCKINGHAM DR.
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335
Practice Address - Country:US
Practice Address - Phone:248-986-6238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1076112001Medicaid