Basic Information
| Provider Information | |||||||||
| NPI: | 1952337784 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DIGITRACE CARE SERVICES INC | ||||||||
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| OtherOrganizationName: | SLEEPMED | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 CORPORATE PLACE | ||||||||
| Address2: | 5B | ||||||||
| City: | PEABODY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9785367400 | ||||||||
| FaxNumber: | 9785359778 | ||||||||
| Practice Location | |||||||||
| Address1: | 270 COMMUNICATION WAY | ||||||||
| Address2: | 4B | ||||||||
| City: | HYANNIS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 026011883 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174729821 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2006 | ||||||||
| LastUpdateDate: | 05/20/2016 | ||||||||
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| AuthorizedOfficialLastName: | ROSE | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | VP OF FINANCE AND ADMINISTRATION | ||||||||
| AuthorizedOfficialTelephone: | 9785367400 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QS1200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Sleep Disorder Diagnostic |
ID Information
| ID | Type | State | Issuer | Description | 0274 | 01 | MA | NEIGHBORHOOD HEALTH RI | OTHER | 3400027 | 01 | MA | UNITED HEALTHCARE | OTHER | 607536 | 01 | MA | TUFTS | OTHER | 6178 | 01 | MA | FALLON | OTHER | 2860005 | 01 | MA | AETNA HMO | OTHER | 626067 | 01 | MA | HARVARD PILGRIM | OTHER | 7618325 | 01 | MA | AETNA PPO | OTHER | 22164 | 01 | MA | BCBS RI | OTHER | SF038169 | 01 | MA | BCBS OF MA | OTHER | 409503 | 01 | MA | BLUE CHIP | OTHER | 9468 | 01 | MA | NEIGHBORHOOD HEALTH MA | OTHER |