Organization
DIGITRACE CARE SERVICES INC
Active
Other names
SleepMed
Organization subpart
No
Provider details
NPI number
Authorized official
CARL R IBERGER (EVP-CFO)
(978) 536-7400
Entity
Organization
Contact information
Practice address
6550 FANNIN ST, SUITE 2417, HOUSTON, TX 77030-2717
(972) 239-3494
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0085DC
BLUE CROSS
TX
05
—
126657902
—
TX
01
—
PL7236
BLUE CROSS
TX
01
—
PL7237
BLUE CROSS
TX
Enumeration date
03/30/2007
Last updated
11/10/2010
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