Provider Demographics
NPI:1669744967
Name:ROMULUS ROME EVALUATION LLC
Entity type:Organization
Organization Name:ROMULUS ROME EVALUATION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CARTDRELL
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-992-2803
Mailing Address - Street 1:10000 WAYNE RD
Mailing Address - Street 2:SUITE 102-A
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-3445
Mailing Address - Country:US
Mailing Address - Phone:734-992-2803
Mailing Address - Fax:734-992-2617
Practice Address - Street 1:10000 WAYNE RD
Practice Address - Street 2:SUITE 102-A
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-3445
Practice Address - Country:US
Practice Address - Phone:734-992-2803
Practice Address - Fax:734-992-2617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty