Provider Demographics
NPI:1639398159
Name:DIGITRACE CARE SERVICES INC
Entity Type:Organization
Organization Name:DIGITRACE CARE SERVICES INC
Other - Org Name:SLEEPMED INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE & ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-536-7400
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:
Practice Address - Street 1:2303 BEL AIR RD
Practice Address - Street 2:SUITE 4
Practice Address - City:FALLSTON
Practice Address - State:MD
Practice Address - Zip Code:21047-2737
Practice Address - Country:US
Practice Address - Phone:410-877-3950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD292359OtherMAMSI
MD071500008Medicaid
MD292359OtherONENET PPO
VA85970002OtherCARE FIRST
MD292359OtherMDIPA
MD419630OtherCARE FIRST
MD520537OtherCARE FIRST
MD85TZDIOtherCARE FIRST
VA85970001OtherCARE FIRST
MD292359OtherOPTIMUM CHOICE
MD85TZDIOtherCARE FIRST