Provider Demographics
NPI:1538114277
Name:DIGITRACE CARE SERVICES INC
Entity Type:Organization
Organization Name:DIGITRACE CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP CFO
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:978-536-6105
Mailing Address - Street 1:200 CORPORATE PL
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:978-535-9757
Practice Address - Street 1:227 CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4394
Practice Address - Country:US
Practice Address - Phone:401-274-5716
Practice Address - Fax:401-272-2646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI22164OtherBCBS OF RI
RI409503OtherBLUE CHIP
RI6178OtherFALLON
RI0274OtherNHP RI
RI607536OtherTUFTS
RISF038169OtherBCBS OF MA
RI2860005OtherAETNA HMO
RI7618325OtherAETNA PPO
RI626067OtherHARVARD PILGRIM
RI3400027OtherUNITED HEALTHCARE
RI9468OtherNHP MA
RI2860005OtherAETNA HMO