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
9610 DEERECO RD, TIMONIUM, MD 21093-2120
(410) 561-3134
(410) 561-3150
Mailing address
200 CORPORATE PL, SUITE 5B, PEABODY, MA 01960-3840
(978) 536-6176
(978) 536-6322
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
259475
MEDICARE PTAN
—
Enumeration date
05/02/2012
Last updated
05/17/2016
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