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
8505 ARLINGTON BLVD, SUITE 450, FAIRFAX, VA 22031-4621
(703) 383-0156
(703) 383-0158
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
05
—
002284081
—
VA
01
—
102822
KAISER
VA
01
—
202073
ANTHEM BCBS - PIN
VA
01
—
252927
MAMSI
VA
01
—
2860005
AETNA
VA
01
—
419630
CARE FIRST
MD
01
—
520537
CARE FIRST
MD
01
—
659561
SOUTHERN HEALTH
VA
01
—
7618325
AETNA
VA
01
—
8011510
CIGNA
VA
01
—
85970001
CARE FIRST
VA
01
—
85970002
CARE FIRST
VA
01
—
85TZDI
CARE FIRST
MD
01
—
MT35
BCBS
VA
Enumeration date
07/09/2006
Last updated
06/26/2008
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