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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
521 E 86TH AVE, SUITE Z, MERRILLVILLE, IN 46410-6173
(212) 769-0777
(219) 755-0608
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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01619296
FEDERAL BCIL
IL
01
8011510
CIGNA
IL
Enumeration date
08/12/2006
Last updated
10/15/2009
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