Healthcare Provider Details

I. General information

NPI: 1982873139
Provider Name (Legal Business Name): DIGITRACE CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 08/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8825 S HOWELL AVE SUITE 101
OAK CREEK WI
53154
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 414-762-1675
  • Fax:
Mailing address:
  • Phone: 414-762-1675
  • 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: ANGELA NAUFUL
Title or Position: VP COMPLIANCE & CONTRACTING
Credential:
Phone: 770-309-2000