Healthcare Provider Details

I. General information

NPI: 1235335704
Provider Name (Legal Business Name): DIGITRACE CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 05/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 W EXCHANGE ST STE 100B
PROVIDENCE RI
02903-1004
US

IV. Provider business mailing address

200 CORPORATE PL SUITE 5B
PEABODY MA
01960-3840
US

V. Phone/Fax

Practice location:
  • Phone: 401-831-0607
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: JOSEPH ROSE
Title or Position: VP OF FINANCE AND ADMINISTRATION
Credential:
Phone: 978-536-6105