Provider Demographics
NPI:1215211602
Name:DIGITRACE CARE SERVICES, INC.
Entity Type:Organization
Organization Name:DIGITRACE CARE SERVICES, INC.
Other - Org Name:SLEEPMED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP-CAO
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:IBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-536-7400
Mailing Address - Street 1:200 CORPORATE PLACE
Mailing Address - Street 2:SUITE 5B
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-3840
Mailing Address - Country:US
Mailing Address - Phone:978-536-7400
Mailing Address - Fax:978-535-9778
Practice Address - Street 1:1185 N. CONCORD STREET
Practice Address - Street 2:SUITE 411
Practice Address - City:SOUTH ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55075-1187
Practice Address - Country:US
Practice Address - Phone:651-457-4293
Practice Address - Fax:651-457-4910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-04
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic