Healthcare Provider Details

I. General information

NPI: 1952337784
Provider Name (Legal Business Name): DIGITRACE CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 05/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 COMMUNICATION WAY 4B
HYANNIS MA
02601-1883
US

IV. Provider business mailing address

200 CORPORATE PLACE 5B
PEABODY MA
01960
US

V. Phone/Fax

Practice location:
  • Phone: 617-472-9821
  • Fax:
Mailing address:
  • Phone: 978-536-7400
  • Fax: 978-535-9778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH ROSE
Title or Position: VP OF FINANCE AND ADMINISTRATION
Credential:
Phone: 978-536-7400