Organization
DIGITRACE CARE SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL R IBERGER (EVP-CFO)
(978) 536-7400
Entity
Organization
Contact information
Practice address
200 MEDICAL PKWY, SUITE 109, CHESAPEAKE, VA 23320-4911
(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
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7618325
AETNA
—
Enumeration date
06/21/2007
Last updated
10/15/2009
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