Organization Name: | DIGITRACE CARE SERVICES, INC. |
NPI Number: | 1215211602 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CARL IBERGER (EVP-CAO) |
Mailing Address: | 1185 N. Concord Street Suite 411 South St Paul |
State: | MN US |
Postal Code: | 550751187 |
Phone Number: | 6514574293 |
Fax Number: | 6514574910 |
NPI Enumeration Date: | 10/04/2011 |
NPI Last Update Date: | 04/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QS1200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Sleep Disorder Diagnostic |
Taxonomy Definition: |