Healthcare Provider Details

I. General information

NPI: 1003035544
Provider Name (Legal Business Name): DIGITRACE CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 05/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3299 WOODBURN RD SUITE 250-A
ANNANDALE VA
22003-1275
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 703-876-9870
  • Fax:
Mailing address:
  • Phone: 978-536-7400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

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