Provider Demographics
NPI:1467547927
Name:ALLIS, ROOPALEE
Entity Type:Individual
Prefix:
First Name:ROOPALEE
Middle Name:
Last Name:ALLIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10626 STONEY FIELD COURT
Mailing Address - Street 2:
Mailing Address - City:PINCKNEY
Mailing Address - State:MI
Mailing Address - Zip Code:48169
Mailing Address - Country:US
Mailing Address - Phone:734-878-5871
Mailing Address - Fax:
Practice Address - Street 1:2215 FULLER COURT (30)
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105
Practice Address - Country:US
Practice Address - Phone:734-769-7100
Practice Address - Fax:734-213-6993
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26016992A183500000X
MI5302029809183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist