Provider Demographics
NPI: | 1821245309 |
---|---|
Name: | DIGITRACE CARE SERVICES, INC |
Entity Type: | Organization |
Organization Name: | DIGITRACE CARE SERVICES, INC |
Other - Org Name: | SLEEPMED |
Other - Org Type: | Other Name |
Authorized Official - Title/Position: | VP COMPLIANCE & CONTRACTING |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ANGELA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | NAUFUL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 770-309-2000 |
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: | 332 PLEASANT ST |
Practice Address - Street 2: | |
Practice Address - City: | NORTHAMPTON |
Practice Address - State: | MA |
Practice Address - Zip Code: | 01060 |
Practice Address - Country: | US |
Practice Address - Phone: | 978-536-7400 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-08-26 |
Last Update Date: | 2018-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MA | 327004 | Other | BCBS |