Organization
DIGITRACE CARE SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL R. IBERGER (EVP,CFO)
(978) 536-7400
Entity
Organization
Contact information
Practice address
2060 N VALLEY MILLS DR, WACO, TX 76710-2561
(254) 741-0455
(254) 741-6968
Mailing address
200 CORPORATE PL, SUITE 5B, PEABODY, MA 01960-3840
(978) 536-7400
(978) 535-9757
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0085DC
BLUE CROSS
TX
01
—
103364101
FIRST CARE
TX
05
—
126657901
—
TX
01
—
7618325
AETNA
—
01
—
PL7236
BLUE CROSS
TX
01
—
PL7237
BLUE CROSS
TX
Enumeration date
07/04/2006
Last updated
10/15/2009
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