Provider Demographics
NPI:1083292247
Name:I-IMAN'S MEDICAL AND LABORATORY SERVICES
Entity Type:Organization
Organization Name:I-IMAN'S MEDICAL AND LABORATORY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONETTA
Authorized Official - Middle Name:CAREY
Authorized Official - Last Name:COVINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:225-266-9186
Mailing Address - Street 1:27 LYMAN ST APT D103
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01103-1282
Mailing Address - Country:US
Mailing Address - Phone:413-285-7762
Mailing Address - Fax:
Practice Address - Street 1:27 LYMAN ST APT D103
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-1282
Practice Address - Country:US
Practice Address - Phone:413-285-7762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center