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
1 HIGGINS ST, AUGUSTA, ME 04330-6312
(207) 623-1735
(207) 623-1845
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
—
626067
HARVARD PILGRIM
ME
01
—
7618325
AETNA
—
01
—
84Z100703ME01
ANTHEM NON-PAR
ME
Enumeration date
08/07/2006
Last updated
01/20/2010
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