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Organization

DIGITRACE CARE SERVICES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CARL R IBERGER (EVP-CFO)
(978) 536-7400
Entity
Organization

Contact information

Practice address
8700 N STEMMONS FWY, SUITE 135, DALLAS, TX 75247-3729
(978) 536-7400
Mailing address
200 CORPORATE PL, SUITE 5B, PEABODY, MA 01960-3840
(978) 536-7400

Taxonomy

Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
293D00000X
Physiological Laboratory
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0085DC
BLUE CROSS
TX
01
103364100
FIRST CARE
TX
01
7618325
AETNA
01
PL7236
BLUE CROSS
TX
Enumeration date
03/30/2007
Last updated
07/23/2008
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