Provider Demographics
NPI:1518726868
Name:IMQRA LLC
Entity Type:Organization
Organization Name:IMQRA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:QUINETTE
Authorized Official - Middle Name:AUSTINA
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-664-5834
Mailing Address - Street 1:12814 MURPHY GROVE TER
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-4318
Mailing Address - Country:US
Mailing Address - Phone:732-664-5834
Mailing Address - Fax:
Practice Address - Street 1:12814 MURPHY GROVE TER
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:MD
Practice Address - Zip Code:20871-4318
Practice Address - Country:US
Practice Address - Phone:732-664-5834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health