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
17115 RED OAK DR, SUITE 202 & 204, HOUSTON, TX 77090-2641
(281) 583-8228
(281) 583-8668
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
BCBS
TX
01
—
103364100
FIRST CARE
TX
01
—
7618325
AETNA
—
Enumeration date
08/11/2006
Last updated
03/11/2008
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