1952337784 NPI number — DIGITRACE CARE SERVICES INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952337784 NPI number — DIGITRACE CARE SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DIGITRACE CARE SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952337784
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/20/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 CORPORATE PLACE
Provider Second Line Business Mailing Address:
5B
Provider Business Mailing Address City Name:
PEABODY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01960
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-536-7400
Provider Business Mailing Address Fax Number:
978-535-9778

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
270 COMMUNICATION WAY
Provider Second Line Business Practice Location Address:
4B
Provider Business Practice Location Address City Name:
HYANNIS
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02601-1883
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-472-9821
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ROSE
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
Authorized Official Title or Position:
VP OF FINANCE AND ADMINISTRATION
Authorized Official Telephone Number:
978-536-7400

Provider Taxonomy Codes

  • Taxonomy code: 261QS1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0274 . This is a "NEIGHBORHOOD HEALTH RI" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 3400027 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 607536 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 6178 . This is a "FALLON" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2860005 . This is a "AETNA HMO" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 626067 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 7618325 . This is a "AETNA PPO" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 22164 . This is a "BCBS RI" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: SF038169 . This is a "BCBS OF MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 409503 . This is a "BLUE CHIP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 9468 . This is a "NEIGHBORHOOD HEALTH MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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