Organization
DIGITRACE CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL R IBERGER (EVP-CFO)
(978) 536-7400
Entity
Organization
Contact information
Practice address
130 2ND ST, NEENAH, WI 54956-2883
(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
—
196050540331
HUMANA
WI
05
—
32798300
—
WI
01
—
3501696
UNITED HEALTH CARE
WI
Enumeration date
03/30/2007
Last updated
10/15/2009
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