Provider Demographics
NPI:1003035510
Name:DIGITRACE CARE SERVICES INC
Entity type:Organization
Organization Name:DIGITRACE CARE SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 1:6931 ARLINGTON RD
Practice Address - Street 2:T300-A
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-5231
Practice Address - Country:US
Practice Address - Phone:301-251-5905
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
MD071500005Medicaid
MD292359OtherMDIPA
MD292359OtherOPTIMUM CHOICE
MD292359OtherMAMSI
MD659561OtherSOUTHERN HEALTH
MD292359OtherONENET PPO
MD419630OtherCARE FIRST
VA85970002OtherCARE FIRST
VA85970001OtherCARE FIRST
VA8597001OtherCARE FIRST
MD520537OtherCARE FIRST
MD85TZDIOtherCARE FIRST
MD520537OtherCARE FIRST
MDFDS015Medicare PIN