Organization
DIGITRACE CARE SERVICES INC
Active
Other names
Sleepmed Inc
Organization subpart
No
Provider details
NPI number
Authorized official
CARL R IBERGER (EVO-CFO)
(978) 536-7400
Entity
Organization
Contact information
Practice address
3413 OLANDWOOD CT, # 103, OLNEY, MD 20832-1489
(301) 251-5905
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
05
—
071500004
—
MD
01
—
292359
MAMSI
MD
01
—
419630
CARE FIRST
MD
01
—
520537
CARE FIRST
MD
01
—
659561
SOUTHERN HEALTH
MD
01
—
85970001
CARE FIRST
VA
01
—
85970002
CARE FIRST
VA
01
—
85TZDI
CARE FIRST
MD
Enumeration date
04/24/2007
Last updated
10/15/2009
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