Organization
DIGITRACE CARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH ROSE (VP OF FINANCE & ADMINISTRATION)
(978) 536-7400
Entity
Organization
Contact information
Practice address
1015 CHESTNUT ST, STE 917, PHILADELPHIA, PA 19107-4316
(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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000020417
HIGHMARK- BC/BS OF PA
PA
01
—
0453320000
BC/BS PERSONAL CHOICE PPO
PA
01
—
0658107000
KEYSTONE
PA
01
—
7618325
AETNA
PA
Enumeration date
02/25/2009
Last updated
05/17/2016
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